Staphylococcal skin scalded syndrome:
In neonates, young children, and immunocompromised individuals enough toxin can be produced by a localized infection and released into the blood stream to cause widespread superficial exfoliation resulting in staphylococcal scalded skin syndrome. Most individuals seem to acquire neutralizing antibodies to this toxin during childhood and thus this disease tends to be restricted to the young or the immunoimpaired. Since the toxin is primarily eliminated through the kidneys, patients with renal failure may also be at risk. It should not be confused with the much more serious form of epidermal sloughing, toxic epidermal necrolysis (TEN), which involves the loss of the entire epidermal surface, not just the stratum corneum. TEN is a dermatologic emergency treated like a widespread burn injury and is most often secondary to a drug reaction.