郭秀梅

[摘要] 目的 了解局部地区葡萄球菌性烫伤样皮肤综合征患者的年发病情况、发病季节、性别比例、诱发因素、发病年龄、临床表现、病程及治疗。 方法 对2009年1月～2013年12月5年内就诊于本院皮肤科与儿科的18例葡萄球菌性烫伤样皮肤综合征患者进行流行病学调查。 结果 发病在7～11月12例，12～6月6例。5例患者有外伤、脓疱疮、蚊虫叮咬病史。发病年龄最小11个月，最大13岁。所有患者均表现为触痛性红斑及口周放射性皲裂。病程在8～13 d。无败血症及死亡病例出现。 结论 在局部地区限局性时间内，葡萄球菌性烫伤样皮肤综合征呈现散发性发病状态，男女性别患病率相同。外伤、脓疱疮、蚊虫叮咬可成为本病的诱发因素。小剂量糖皮质激素联合抗生素治疗有效，预后良好。

[关键词] 葡萄球菌；烫伤样皮肤综合征；流行病学；报告

[中图分类号] R753 [文献标识码] A [文章编号] 1674-4721（2014）04（b）-0056-03

[Abstract] Obejective To report the annual incidence，incidence of the season，gender ratio，predisposing factors，incidence of the age，clinical presentation，course and treatment of Staphylococcus scalded skin syndrome.Methods 18 cases of patients with Staphylococcus scalded skin syndrome treated in Department of Dermatology and Pediatrics in our hospital from January 2009 to November 2013 were taken with epidemiological investigation.Results In 18 patients，12 cases fell ill between July and November，6 cases fell ill between December and June of the next year.5 cases had history of trauma，impetigo，mosquito bites.The youngest incidence of the age was 11 months and the oldest was 13 years old.Perioral erythema and tenderness radioactive chapped was appeared to all patients.Course of disease was 8 to 13 days.No sepsis and deaths occured.Conclusion In the local area and limited time，Staphylococcus scalded skin syndrome shows sporadic onset status.The prevalence is same in different gender.Trauma，impetigo，mosquito bites can be as predisposing factor of the disease.Low dose of glucocorticoid combined with antibiotic is effctive，the prognosis is good.

[Key words] Staphylococcus；Scalded skin syndrome；Epidemiology；Report

金黄色葡萄球菌性烫伤样皮肤综合征致病菌是金黄色葡萄球菌，主要是凝固酶阳性第Ⅱ噬菌体组金葡菌（尤其是71型）所致[1]。此种菌可以产生一种可溶性毒素——表皮松解毒素，即剥脱毒素，此毒素可通过蛋白水解过程发挥作用[2]，作用于表皮颗粒层，造成皮肤损伤。表现为发热、腔口周围、皮肤皱褶处触痛性红斑，表皮剥脱，似烫伤样改变，严重者可出现败血症，甚至死亡，其中口周放射性皲裂有特殊的诊断意义[3]。好发于6岁及以下幼儿，罕见的成人葡萄球菌性烫伤样皮肤综合征患者伴有原发疾病，如免疫抑制、免疫异常、肾功能不全等[4]。……