Syndromes Resembling Scalding of the Skin

When the skin is exposed to thermal injury such as scalding, significant damage occurs to the epidermis and it may become dislodged and wiped away in large sheets. Several syndromes in which epidermal injury occurs, by unrelated mechanisms, may also lead to extensive loss of epidermal tissue that resembles scalded skin. Because of their clinical resemblance to one another, considerable confusion in terminology has persisted. Significant progress has occurred in recent years to distinguish the different syndromes which resemble scalding of the skin. Immunological phenomena play a role in some if not all of these syndromes. This chapter will include the staphylococcal epidermolytic toxin syndrome (SETS), toxic epidermal necrolysis (TEN), graft-vs.-host (GvH) disease, and erythema multiforme.