[Staphylogenous Lyell's syndrome]

Abstract

The scalded skin syndrome or Lyell syndrome can now be divided into two distinct forms. One form is associated with staphylococci that are usually phage group II Staphylococcus aureus, are penicillin resistant, and produce a protein exotoxin which produces epidermolysis by causing a split to develop in the epidermis between the stratum granulosum and the stratum spinosum. The other form is associated usually with drug reactions and is characterized by necrosis of the epidermis with a split between epidermis and dermis. The staphylococcal Lyell syndrome should be treated with penicillinase resistant antibiotics and not with corticosteroids; the non-staphylococcal form of the Lyell syndrome often requires systemic corticosteroids. Therefore the correct diagnosis must be established early. This is possible since the histopathology of the two forms is different.