Lee Jonathan J, Tsibris Hillary C, Mostaghimi Arash, Lian Christine G
Program in Dermatopathology, Department of Pathology, Boston, Mass., USA.
Harvard Combined Dermatology Residency Program, Harvard Medical School, Boston, Mass., USA.
Dermatopathology (Basel). 2014 Oct 31;1(2):75-80. doi: 10.1159/000368599. eCollection 2014 Aug-Dec.
Staphylococcal scalded skin syndrome is a toxin-mediated, epidermolytic condition that uncommonly affects adults. A 51-year-old man receiving chemotherapy for leukemia presented with a large geographic erosion with superficial sloughing and multiple smaller lesions elsewhere. Biopsy revealed complete subcorneal splitting with multiple detached fragments of normal-appearing stratum corneum with fragments of attached acantholytic granular keratinocytes. Mild epidermal dysmaturation was also noted. Based on these findings, the patient was started on oral cephalexin, topical mupirocin, and topical clobetasol. His lesions improved significantly over the course of 1 week.
葡萄球菌性烫伤样皮肤综合征是一种由毒素介导的表皮松解性疾病,在成人中较少见。一名51岁因白血病接受化疗的男性患者出现大片地图状糜烂,伴有表皮浅层脱落,其他部位还有多个较小的皮损。活检显示角质层下完全分离,出现多个外观正常的角质层分离碎片,伴有棘层松解性颗粒状角质形成细胞碎片。还注意到轻度表皮发育异常。基于这些发现,患者开始口服头孢氨苄、外用莫匹罗星和外用丙酸氯倍他索。在1周的病程中,他的皮损明显改善。