Staphylococcal scalded skin syndrome in a homosexual adult

A homosexual man developed staphylococcal scalded skin syndrome associated with a Staphylococcus aureus septicemia. We discuss the role of prednisone, renal insufficiency, and immunosuppression as predisposing factors to staphylococcal scalded skin syndrome in adults. In particular, our study of the patient's immune function revealed anergy and lymphopenia, with a reduced response to phytohemagglutinin. Studies of T cell subpopulations revealed an elevated percentage of T suppressor cells and a diminished percentage of T helper cells with a depressed T helper/T suppressor ratio. Because of those abnormalities, we suspected acquired immunodeficiency syndrome. A few months after recuperation from the acute disease, the patient has had a normalization of the T helper/T suppressor ratio, but because of persistent polyadenopathy, hypergammaglobulinemia, and a negative sensitization to keyhole-limpet hemocyanin (KLH), we now consider the patient to have an acquired immunodeficiency syndrome-related complex.