葡萄球菌性烫伤样皮肤综合征继发卡波西水痘样疹

A case of staphylococcal scalded skin syndrome with Kaposi varicelliform eruption

报告1例葡萄球菌性烫伤样皮肤综合征继发卡波西水痘样疹。患儿男,2岁。面部、躯干及四肢出现脓疱、糜烂伴疼痛5 d。住院4 d后患儿面部出现新发皮损,以口周为重。皮肤科检查:(入院时)口周、眼周放射状裂纹及糜烂面,上覆黄色结痂,眼睑及周围轻度红肿。双侧外耳道、鼻腔可见糜烂面上覆黄色结痂,皮损处触痛阳性,尼氏征阳性。(住院4 d后)面、颈部可见新发散在绿豆大红色丘疹、丘疱疹及水疱,部分水疱可见脐凹,以口周为重,额部干燥脱屑。实验室检查:单纯疱疹病毒抗体(HSV1/2-IgG)阳性。诊断:葡萄球菌性烫伤样皮肤综合征继发卡波西水痘样疹。治疗:予静脉滴注头孢美唑联合外用夫西地酸抗感染,后加用阿昔洛韦抗病毒治疗,治疗后患儿皮损基本消退,遗留散在结痂。

A case of staphylococcal scalded skin syndrome with Kaposi varicelliform eruption is reported. A two-year-old boy presented with multiple pustules and erosions on the whole body with pain for 5 days. Physical examination showed perioral and periocular crusting and radial fissuring with erosion and crusting, together with mild eyelid swelling, were presented at external auditory canal, nasal cavity, and trunk. Erythema could be seen at perioral and periocular areas, neck, and armpit. Nikolsky’s sign and tenderness were positive. At fourth day in hospital, new small scattered red papules appeared on his face and neck, clustered around the mouth. And soon some papules progressed to umbilicated vesicles and pustules. Laboratory tests showed herpes simplex virus antibody was positive(HSV1/2-IgG≥30 U/mL). The diagnosis of staphylococcal scalded skin syndrome with Kaposi varicelliform eruption was made. The patient was treated with intravenous infusion of cefmetazole, topical fusidic acid cream, and later with combined intravenous infusion of acyclovir. After treatment, the skin lesions disappeared, leaving scattered scabs.