Dermatologic Emergencies

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1. Staphylococcal scaled skin syndrome
This condition associated with high mortality is seen commonly in infants and children.
It is caused by Staphylococcus aureus Phage Type 71 due to liberation of the exotoxin exfoliation. It is characterized by diffuse erythema and fever. Large flaccid bullae with clear fluid form and rupture almost immediately.

This condition warrants admission, extremely good nursing care (like that of Burns/Scalds), maintenance of fluid and electrolyte balance. Appropriate antibiotics should be used, role of systemic corticosteroids in debatable.

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Exfoliative dermatitis includes also Seborrhea for which a steroid i.e. Betamethasone Valerate 0.2% is prescribed. However a good scrubbing with bath salts, like skin-friendly Epsom Salt (Magnesium Sulphate) after a shower, will have the same temporary effect, without the nasty side-effects of Steroids. On the scalp Alcohol will prevent excessive dandruff for a day or so.


Why this difference between type 1 and type 2 reactions and why there is difference even in treatment also .

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