Staphylococcal scalded skin syndrome in an adult

A 68-year-old man developed areas of erythema with flaccid bullae and wrinkling on his face, upper extremities, chest, right buttock, and shins. Histological examination revealed an intraepidermal cleavage with a sparse cellular infiltration in the dermis, consistent with a diagnosis of staphylococcal scalded skin syndrome. Cultures from an abscess of his right knee joint and his blood were both positive for Staphylococcus aureus. Both S. aureus isolates were confirmed to be double-producers of ETA and ETB using the polymerase chain reaction. The use of nonsteroidal anti-inflammatory drug seemed to be one of the predisposing factors in this patient.