We welcome the interest in and different interpretation of the data reported in our recent study concerning the association of virulence factors of Staphylococcus aureus with the degree of local inflammatory response in infected skin lesions.1 Our study focused on superficial skin infections and whether S aureus isolated from these lesions had the potential to produce immune system–modulating toxins. We also correlated findings with WBC counts associated with these lesions. It is certainly valid to highlight the proinflammatory response that is associated with the presence of PVL-positive S aureus strains2,3; however, the association of PVL with this bacterial population was not a novel or an unexpected finding. Clearly, the proinflammatory properties of PVL contributed to the high level of inflammatory cell infiltrate in some of these lesions.
Plano LRW, Davis SC, Mertz PM. Panton-Valentine Leukocidin, Exfoliative Toxins, and Skin Infections—Reply. Arch Dermatol. 2008;144(8):1070. doi:10.1001/archderm.144.8.1070-a