Generalized Eruptions

Generalized Eruptions


There are drug eruptions, viral and bacterial exanthems that can become widespread and occasionally life-threatening. Erythema multiforme major (Stevens-Johnson syndrome), toxic epidermal necrolysis, and exfoliative dermatitis (erythroderma) may produce generalized eruptions and present as medical emergencies. Staphylococcal scalded skin syndrome (SSSS), however, has a generally benign outcome with a very low mortality.

Erythema multiforme major, also known as Stevens-Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN) are now believed to be variants of the same condition on a spectrum of clinical presentations and are often referred to as “SJS/TEN.” They are discussed separately in this chapter because of several of their unique cutaneous manifestations.

Staphylococcal Scalded Skin Syndrome

Distinguishing Features

SSSS presents as an erythematous rash followed by diffuse epidermal exfoliation characterized by the appearance of large fluid-filled flaccid bullae that rupture easily, leaving an area that looks like a burn (Figs. 20-1 and 20-2).

  • Fever, although patients may be afebrile; in fact, most patients do not appear severely ill

  • Tenderness and warmth on palpation

  • Nikolsky sign: gentle stroking of the skin results in a separation of the epidermis at the dermal-epidermal junction resulting in the dislodgement of intact superficial epidermis

  • Exfoliation may be patchy or sheet-like in nature

  • Facial edema

  • Perioral crusting

  • Dehydration may be present and significant

Exfoliative Dermatitis (Erythroderma)

Jan 8, 2023 | Posted by in Dermatology | Comments Off on Generalized Eruptions
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