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