葡萄球菌性烫伤样皮肤综合征35例临床分析

Clinical analysis of 35 patients with staphylococcal scalded skin syndrome

目的:分析葡萄球菌性烫伤样皮肤综合征(staphylococcal scalded skin syndrome,SSSS)的发病年龄、诱发因素、临床表现、实验室检查、治疗及预后。方法:回顾性分析35例儿童金葡菌烫伤样皮肤综合征的临床资料。结果:35例病例中,有21例发生于3岁以内婴幼儿,约占总病例的60%;发病中位年龄为2岁5个月;皮损主要表现为触痛性红斑、松弛性大疱、表皮剥脱(100%),口周放射状皲裂(94.3%),发热(42.9%),结膜炎(37.1%),实验室检查血白细胞及C反应蛋白未见显著性升高。结论:SSSS近年来时有发生,婴幼儿触痛性红斑、松弛性大疱、表皮剥脱伴口周放射状裂纹时应高度怀疑本病。早期、足量、有效的使用抗生素,是治疗的关键,联合大剂量静脉注射免疫球蛋白,可明显缩短病程。

Objective：To describe the causative factor, onset age, clinical manifestation, laboratory examination and therapy of 35 cases of staphylococcal scalded skin syndrome （SSSS）. Methods： We present an observational cohort study. We review the cases of staphylococcal scalded skin syndrome monitored at in patient department during the last ten years （January 1998 to December 2007）. Results：We obtained 35 patients, 21 cases （60%） occurred during in the first 3 years. The mean age at diagnosis was 29 months. Main clinical signs were： tender erythroderma with flaccid blisters and posterior desquamation （ 100% ） , perioral fissures （94. 3% ）, fever （42.9%）, and conjunctivitis （37.1%）. No significant increases in leukocytes or C -reactive protein were found on blood analysis. Conclusion：Staphylococcal scalded skin syndrome seems to be more common in the last few years. It must be suspected in children with acute erythroderma, flaccid blisters, posterior desquamation and perioral fissures. Treatment with effective and enough antibiotic as soon as earlier leads to healing without sequelae. To combine with high -dose intravenous immunoglobulin approved to shorten the course of disease.