Exfoliatin produced by Staphylococcus aureus causes which syndrome?

• A. Scalded skin syndrome
• B. Enterocolitis
• C. Toxic shock syndrome
• D. Staphylococcal pneumonia

Answer: (A)

Exfoliative toxins produced by Staphylococcus aureus act as specific proteases that target desmoglein-1 in the superficial epidermis. This disrupts cell-to-cell adhesion in the stratum granulosum, causing a clean, intraepidermal split and widespread desquamation. The result is a tender, red, peeled skin appearance often described as scalded, with mucous membranes spared. Clinically this is Staphylococcal Scalded Skin Syndrome, commonly seen in young children and sometimes in adults with kidney issues. The other options involve different toxin effects or infections (toxic shock syndrome from a superantigen, enterocolitis from enterotoxins, pneumonia from direct infection), not the toxin that cleaves desmoglein-1 or the distinctive skin-shedding pattern.