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KMID : 1141320190340020138
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Kosin Medical Journal
2019 Volume.34 No. 2 p.138 ~ p.145
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The Characteristics of Staphylococcal Scalded Skin Syndrome in Atopic Dermatitis
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Jung Woo-Jin
Kim Sung-Won
Hwang Yoon-Ha
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Abstract
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Objectives: Staphylococcal scalded skin syndrome (4S), a blistering dermatosis caused by exfoliative toxins from Staphy-lococcus aureus, occurs frequently in patients with atopic dermatitis (AD). However, association between 4S and AD has not rarely been reported. We investigated the characteristics of 4S according to AD status.
Methods: The study included 146 children with 4S who visited Busan St. Mary’s Hospital from 2007?2018. Clinical fea-tures were analyzed from medical records and pictures, and 4S was classified as localized or generalized. We also retro-spectively investigated the preceding conditions and test results related to AD.
Results: Among 146 patients with 4S, median age was 2.0 years, and 35 (24.0%) had AD. Since 2007, the incidence of both 4S and AD have increased, without obvious seasonal patterns. Generalized and localized disease occurred in 90 and 56 patients, respectively. Twenty-four of 35 patients with AD (68.6%) and 32 of 111 (28.8%) without AD had localized disease. Significant differences were observed between the groups (P = 0.000). Among those with AD, the most common preceding condition was skin infection or unknown (45.2%); however, respiratory disease was the most common (47.9%) among patients without AD. Eosinophil levels were higher in the AD group (P = 0.002), and there were no statistically significant differences in total immunoglobulin E (IgE), Dermatophagoides farinae (Df IgE), egg-white IgE, and culture results between the groups.
Conclusions: Localized 4S frequently occurred without preceding conditions in children with AD and usually arose from skin infection compared to generalized 4S.
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KEYWORD
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Atopic dermatitis, Staphylococcal scalded skin syndrome, Staphylococcus aureus
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