Bubbling of Skin!Bubbling of Skin!

By:By:Faith EfadaFaith Efada

David HernandezDavid HernandezZenona HammondZenona Hammond

CaseCase

6 year old girl admitted to hospital6 year old girl admitted to hospitalAcute Blistering of her left arm and handAcute Blistering of her left arm and handNormal Vital signsNormal Vital signs

After ExaminationAfter ExaminationBurns were suspectedBurns were suspected

Conformation of non exposure to burning Conformation of non exposure to burning agentsagents

DifferentialsDifferentials AbuseAbuse BurnsBurns

ChemicalChemical ThermalThermal

Contact Allergy DermatisContact Allergy Dermatis FolliculitisFolliculitis SSSS(Staphylococcal SSSS(Staphylococcal

Scalded Skin Syndrome)Scalded Skin Syndrome) InpetigoInpetigo Toxic Epidermal Toxic Epidermal

Necrolysis Necrolysis Rhus DermatitisRhus Dermatitis Urticaria Urticaria

QuestionsQuestions

Has she been around poison ivy and oak?Has she been around poison ivy and oak?Does she have any allergies?Does she have any allergies?Has she traveled anywhere recently? Has she traveled anywhere recently? Do any of her family members have any Do any of her family members have any

similar symptoms? similar symptoms? Ask the child if her parents have hurt her Ask the child if her parents have hurt her

in any way. in any way. Is she allergic to any medications? Is she allergic to any medications? Is she currently taking any medications? Is she currently taking any medications?

What is it? And how do we know?What is it? And how do we know?

Staphylococcus Scalded Skin SyndromeStaphylococcus Scalded Skin SyndromeStaphylococcus aureusStaphylococcus aureus

GPC in ClustersGPC in Clusters

No AbuseNo AbuseNot been around poison ivy or oakNot been around poison ivy or oak

Contact Allergy/Rhus DermatitisContact Allergy/Rhus Dermatitis

Continued. . . Continued. . .

Not on any meds.Not on any meds.No NecrosisNo Necrosis

Toxic Epidermal NecrosisToxic Epidermal NecrosisType 1 HypersensitivityType 1 Hypersensitivity

UrticariaUrticaria

SSSSSSSS

Exotoxin Exotoxin A & BA & B

Oral/Nasal CavitiesOral/Nasal CavitiesThroatThroatUmbilicusUmbilicus

Binding of toxin btwn cells forming a blisterBinding of toxin btwn cells forming a blisterRed RashRed RashSeparation of Epidermis Separation of Epidermis

Granular Cell Layer Granular Cell Layer

TestsTests

CultureCultureMSA MSA

YellowYellow

Gram StainGram StainGPCGPC

Catalase & CoagulaseCatalase & CoagulasePositivePositive

Portal of EntryPortal of Entry

Person-to-person contactPerson-to-person contactEnters skinEnters skin

CutsCutsWoundsWoundsAny broken skinAny broken skin

Touching of infected areas can aid in Touching of infected areas can aid in spreading spreading

PrognosisPrognosis

Mortality Mortality Children very low 1-5%Children very low 1-5%

DeathDeathSecondary infectionSecondary infection

TreatmentTreatment

Sensitivity test resultsSensitivity test results ResistantResistant

PenicillinPenicillin AmoxicillinAmoxicillin TetracyclineTetracycline CephalexinCephalexin NaficillinNaficillin VancomycinVancomycin

VRSA (Vancomycin VRSA (Vancomycin Resistant Resistant Staphylococcus Staphylococcus Aureus)Aureus)

SensitiveSensitive CiprofloxacinCiprofloxacin

Treatment Cont…Treatment Cont…

As if she were a burn patientAs if she were a burn patientCleaning of the woundsCleaning of the woundsWrappingWrappingMonitoring VitalsMonitoring VitalsFluid input and outputFluid input and outputNutritionNutrition

PreventionPrevention

IsolationIsolationProper PPGProper PPGNon-disposable items to use on a specific Non-disposable items to use on a specific

individualindividualEducateEducateOut of school Out of school

Work CitedWork Cited

Anderson, Douglas. Anderson, Douglas. Mosby’s Medical DictionaryMosby’s Medical Dictionary. . St Louis: Mosby’s Inc., 2002.St Louis: Mosby’s Inc., 2002.

Bauman, Robert. Bauman, Robert. Microbiology: Alternate Edition Microbiology: Alternate Edition with Diseases by Body Systemwith Diseases by Body System. San . San Francisco.Pearson Education Inc., 2006.Francisco.Pearson Education Inc., 2006.

King, Randall, and de Saint Victor, Paul. King, Randall, and de Saint Victor, Paul. “Staphylococcal Scalded Skin Syndrome.” “Staphylococcal Scalded Skin Syndrome.” emedicine Instant Access to the Mind of emedicine Instant Access to the Mind of MedicineMedicine. 1 April 2006. . 1 April 2006. http://www.emedicine.com/emerg/topic782.htm#http://www.emedicine.com/emerg/topic782.htm#section~introductionsection~introduction