SITE OF ACTION OF EXFOLIATIVE TOXIN IN THE STAPHYLOCOCCAL SCALDED-SKIN SYNDROME
1 Departments of Pediatrics and Microbiology, University of Rochester School of Medicine and Dentistry, Rochester, New York
The purpose of this study was to demonstrate morphologic correlates of exposure of skin to exfoliative toxin derived from live phage group II staphylococci. Human infection with these staphylococci has been associated with scarlatiniform rash, generalized exfoliation, or bullous impetigo.
Histologically, the skin lesions in patients and animals injected with the exfoliative toxin appear indistinguishable. The characteristic change is an intraepidermal cleavage through the granular cell layer. Electron microscopically, this cleavage appears to result from disruption of otherwise normal attachment structures (desmosomes) through their intercellular contact area. This disruption may be related to disappearance of extracellular globules which are proposed possibly to contain proteolytic enzymes.
Submitted on April 3, 1972Accepted on July 11, 1972
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