Bullous impetigo. Occurrence of localized scalded skin syndrome in an adult

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Abstract
The localized form of staphylococcal [Staphylococcus aureus] scalded skin syndrome, bullous impetigo, occurs commonly in children but rarely in adults. A case of bullous impetigo in an adult which developed while the patient was receiving short-term therapy with orally administered [immunosuppressing] corticosteroids is described. Scalded skin syndrome was characterized by isolation of phage group 2 staphylococci from intact bullae and by the presence of an intraepidermal, subgranular cleavage plane in histological sections. Features that differentiate the localized form of scalded skin syndrome from generalized forms include the presence of dermal infiltrate and the absence of cutaneous erythema and tenderness. On the basis of available experimental evidence, the rarity of localized and generalized scalded skin syndrome in adults can be attributed to immunologic competence or enhanced capacity of adults to metabolize the staphylococcal exfoliatin.

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