This healthy 5-year-old boy developed generalized erythema followed by edema, erosions, and crusting especially in areas of incidental trauma. He was afebrile but complained of chills and extremely tender skin. The skin eruption was preceded by 2 days of upper respiratory symptoms including sore throat, rhinorrhea, and crusting around the eyes, nose, and mouth. His mucous membranes including the mouth, conjunctivae, urethra, and rectum were spared. He was begun on an oral antistaphylococcal antibiotic pending results of a skin culture from the nares which grew methicillin sensitive Staphylococcus aureus. Although his discomfort worsened over the subsequent 24 hours, within 72 hours he was feeling better, and 4-5 days later he was almost back to normal activity. The following day he began to shed large sheets of skin with normal skin beneath.
generalized erythema, edema and periorificial and intertriginous erosions and crusting