Exfoliative toxin produced by Staphylococcus aureus causes which clinical syndrome?

Exfoliative toxin produced by Staphylococcus aureus causes which clinical syndrome?

• A. Impetigo
• B. Scalded skin syndrome
• C. Toxic shock syndrome
• D. Necrotizing fasciitis

Answer: (B)

Exfoliative toxins from Staphylococcus aureus act as proteases that split desmoglein-1 in the superficial epidermis, leading to loss of cell–cell adhesion in the upper skin layers. This local destruction produces the characteristic widespread skin peeling seen in scalded skin syndrome (Ritter disease), especially in infants and young children who are more susceptible. Clinically, you see widespread erythema, tender skin with bullae that rupture easily, diffuse desquamation, fever, and a positive Nikolsky sign. Impetigo is a localized skin infection with honey-colored crusts, not the extensive epidermal splitting caused by these toxins. Toxic shock syndrome involves systemic illness from a superantigen (not the exfoliative toxin-driven superficial skin split), and necrotizing fasciitis is a deep tissue infection with rapidly spreading necrosis rather than superficial epidermal desquamation.

Exfoliative toxins from Staphylococcus aureus act as proteases that split desmoglein-1 in the superficial epidermis, leading to loss of cell–cell adhesion in the upper skin layers. This local destruction produces the characteristic widespread skin peeling seen in scalded skin syndrome (Ritter disease), especially in infants and young children who are more susceptible. Clinically, you see widespread erythema, tender skin with bullae that rupture easily, diffuse desquamation, fever, and a positive Nikolsky sign.

Impetigo is a localized skin infection with honey-colored crusts, not the extensive epidermal splitting caused by these toxins. Toxic shock syndrome involves systemic illness from a superantigen (not the exfoliative toxin-driven superficial skin split), and necrotizing fasciitis is a deep tissue infection with rapidly spreading necrosis rather than superficial epidermal desquamation.