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Background: Staphylococcal scalded skin syndrome (SSSS) is a toxin‐mediated, blistering skin disorder that mainly affects infants and children. There is limited literature regarding pediatric SSSS. The purpose of this study was to describe the epidemiology, clinical features, and management of pediatric SSSS. Methods: Retrospective cohort study of pediatric patients with a clinical diagnosis of SSSS seen at the Hospital for Sick Children in Toronto, Ontario, Canada, from January 1994 to March 2016. Results: We included 84 patients with a clinical diagnosis of SSSS; 49/84 (58%) were male. Mean age of diagnosis was 3.1 ± 2.4 years. All patients presented with erythema and exfoliation, while 64/84 (76%) presented with vesicles/ bullae. Skin tenderness was the most common symptom, present in 68/84 (81%) subjects. Staphylococcus aureus was more commonly isolated from periorificial cultures than from bullae. Mean hospitalization was 4.7 ± 2.3 days. No difference was found in admission duration between children receiving clindamycin and those that did not (3.6 ± 2.2 vs 3.9 ± 2.34 days, P =.63). Skin debridement was the only risk factor leading to more complications and prolonged hospitalization (P =.03). Severe complications were seen in 4 (5%) cases, and no fatalities were observed. Conclusions: Healthcare providers should be aware of SSSS and consider it in the differential diagnosis of infants and children with new onset erythema, exfoliation, and/or vesiculation. Suspected culprit pathogens were more often obtained from periorificial swabs; however, these isolates were not tested for exfoliative toxin to confirm causality. Antibiotic treatment should be guided by sensitivity testing. Addition of clindamycin as an anti‐toxin agent had no effect on the duration of hospitalization, and this should be further investigated. Surgical debridement of the skin in patients with SSSS should be discouraged. [ABSTRACT FROM AUTHOR]

Background/Objectives: Patients with epidermolysis bullosa (EB) require care of wounds that are colonized or infected with bacteria. A subset of EB patients are at risk for squamous cell carcinoma, and bacterial‐host interactions have been considered in this risk. The EB Clinical Characterization and Outcomes Database serves as a repository of information from EB patients at multiple centers in the United States and Canada. Access to this resource enabled broad‐scale analysis of wound cultures. Methods: A retrospective analysis of 739 wound cultures from 158 patients from 13 centers between 2001 and 2018. Results: Of 152 patients with a positive culture, Staphylococcus aureus (SA) was recovered from 131 patients (86%), Pseudomonas aeruginosa (PA) from 56 (37%), and Streptococcus pyogenes (GAS) from 34 (22%). Sixty‐eight percent of patients had cultures positive for methicillin‐sensitive SA, and 47%, methicillin‐resistant SA (18 patients had cultures that grew both methicillin‐susceptible and methicillin‐resistant SA at different points in time). Of 15 patients with SA‐positive cultures with recorded mupirocin susceptibility testing, 11 had mupirocin‐susceptible SA and 6 patients mupirocin‐resistant SA (2 patients grew both mupirocin‐susceptible and mupirocin‐resistant SA). SCC was reported in 23 patients in the entire database, of whom 10 had documented wound cultures positive for SA, PA, and Proteus species in 90%, 50%, and 20% of cases, respectively. Conclusions: SA and PA were the most commonly isolated bacteria from wounds. Methicillin resistance and mupirocin resistance were reported in 47% and 40% of patients tested, respectively, highlighting the importance of ongoing antimicrobial strategies to limit antibiotic resistance. [ABSTRACT FROM AUTHOR]

Presents a case report of an infant diagnosed with epidermolysis bullosa (EB) with severe laryngeal involvement that required tracheostomy and other topics. Review of the frequency and extent of head and neck involvement in EB cases at the Hospital for Sick Children in Toronto, Ontario; Physical examination findings; Respiratory complications involved; Postoperative management.