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[Staphylococcal epidermal exfoliation (Ritter's disease)].

R Ruiz Maldonado, L Tamayo, V Vazquez

    Medicina Cutanea Ibero-Latino-Americana
    |January 1, 1976
    PubMed
    Summary
    This summary is machine-generated.

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    Staphylococcus aureus causes staphylococcal epidermal exfoliation (SEE) through a toxin, distinct from toxic epidermal necrolysis. This finding reclassifies Ritter's disease, impacting pediatric dermatology and infectious disease research.

    Area of Science:

    • Bacteriology
    • Dermatology
    • Pathology

    Context:

    • Ritter's disease, a condition affecting newborns and infants, has been historically challenging to classify.
    • The etiological agent and pathogenic mechanisms of staphylococcal epidermal exfoliation (SEE) require precise definition.

    Purpose:

    • To propose "staphylococcal epidermal exfoliation" (SEE) as the most accurate designation for Ritter's disease.
    • To elucidate the physiopathological basis for SEE, identifying Staphylococcus aureus as the causative agent.

    Summary:

    • Staphylococcus aureus (S. aureus) is confirmed as the etiological agent of SEE in humans, fulfilling Koch's postulates.
    • A thermostable toxin produced by S. aureus induces epidermal cell separation at the stratum granulosum, leading to exfoliation in neonates and infant mice.

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  • Experimental evidence in adult mice demonstrates that viable S. aureus causes impetigo-like lesions, while its heat-killed form or isolated toxin does not induce SEE.
  • SEE and toxic epidermal necrolysis are differentiated based on histopathology, therapeutic response, and prognosis, establishing them as distinct entities.

    • Impact:

    • Reclassifies Ritter's disease under the more precise term "staphylococcal epidermal exfoliation."
    • Provides a clear etiological and pathophysiological understanding of SEE, crucial for accurate diagnosis and treatment in neonates.
    • Establishes SEE and toxic epidermal necrolysis as independent clinical and pathological entities, refining dermatological nosology.