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Arch Hand Microsurg > Volume 23(4); 2018 > Article
Archives of Hand and Microsurgery 2018;23(4):271-276.
Published online December 1, 2018.
DOI: https://doi.org/10.12790/ahm.2018.23.4.271   
Staphylococcal Scalded Skin Syndrome in a Healthy Adult: Easy to Misdiagnose
Hong Il Kim, Chan Yee Kwak, Eon Ju Park
Department of Plastic and Reconstructive Surgery, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Korea. pskwakcy@naver.com
Received: 6 August 2018   • Revised: 31 August 2018   • Accepted: 3 September 2018
Abstract
A 60-year-old male presented with a three-month history of redness and swelling on his left little finger. His medical history was not informative. Wound culture revealed methicillin-resistant Staphylococcus aureus. After vancomycin administration, the skin lesions became worse and whole body bullae and desquamation occurred. This was initially suspected to be a drug eruption; thus, we switched antibiotics from vancomycin to teicoplanin. However, biopsy revealed Staphylococcal scalded skin syndrome (SSSS). After several days, generalized skin symptoms improved. The patient recovered and is in good physical health without recurrence six months later. We describe a localized form of SSSS, which is very rare in healthy adults. Consequently, there is a high risk of misdiagnosis. Thus, we report a rare case of SSSS in a healthy adult and the importance of early histological examination for accurate diagnosis.
Key Words: Cellulitis, Drug eruption, Staphylococcal scalded skin syndrome, Vancomycin
 
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