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September 1983

Exfoliative Dermatitis in an Infant: Association With Enterotoxin F—Producing Staphylococci

Author Affiliations

From the Department of Pediatrics (Dr Chesney) and the Division of Dermatology, Department of Medicine (Dr McDonald), University of Wisconsin School of Medicine; the Infant Intensive Care Unit, St Mary's Hospital (Drs Jaucian and McDonald); the Department of Food Microbiology & Toxicology, University of Wisconsin, College of Agricultural & Life Sciences (Dr Bergdoll), Madison; and the Department of Medical Microbiology, Ohio State University, Columbus (Dr Kapral).

Am J Dis Child. 1983;137(9):899-901. doi:10.1001/archpedi.1983.02140350073018

• A 2-month-old premature infant had an extensive exfoliative dermatitis with flaccid bullae, mucous membrane involvement, thrombocytopenia, and an elevated creatinine kinase level. A subepidermal cleavage plane with numerous necrotic epidermal cells and a polymorphonuclear cell infiltrate were present on a skin biopsy specimen. The isolates of Staphylococcus aureus obtained at the onset of her disease had a 29/52 bacteriophage lysis pattern and produced enterotoxins C and F and epidermal toxin, but no exfoliatins. In toxic shock syndrome (TSS), subepidermal blister formation has been described and a new toxin, epidermal toxin, which causes subepidermal cleavage in the newborn mouse model, has been identified. In some infants, exfoliative dermatitis may be a variant of the well-described TSS in older children and adults.

(Am J Dis Child 1983;137:899-901)