SCALDED SKIN SYNDROME

Staphylococcal scalded skin syndrome (SSSS) is disease which is seen p rimarily in newborns and young children and is characterized by a bull ous impetigo, scarlatiniform rash, and subsequently, a generalized exf oliation of surface layers of the epidermis. The name is derived from the scalded appearance of the skin of an infected individual. The dise ase is caused by the staphylococcal exfoliative toxins (ETs), namely, exfoliative toxin type A or type B (ETA or ETB). ETA is a 242-amino ac id protein of 26 951 Da in its mature form, while the mature ETB molec ule is 246 amino acids in length and has a molecular weight of 27 318 Da. These toxins have few multi-organ effects on the host, but rather appear to be specific for, and directed to, the stratum granulosum lay er of the epidermis. While the toxins are non-lethal, and noncytolytic , the exact mechanisms by which the ETs exhibit their characteristic a ctivities remain to be determined. The recent solution of the three-di mensional structure of ETA strongly suggests that the toxin acts as a specific serine-protease in the epidermis.