Pemphigus, bullous impetigo, and the staphylococcal scalded-skin syndrome.

Copyright © 2006 Massachusetts Medical Society. P emphigus, which is caused by autoantibodies, and bullous impetigo (including its generalized form, the staphylococcal scalded-skin syndrome), which is caused by Staphylococcus aureus, are seemingly unrelated diseases. However, 200 years ago, astute clinicians realized that these diseases had enough clinical similarities to call bullous impetigo and the scalded-skin syndrome in infants “pemphigus neonatorum.”1,2 In this review we explain how a common mechanism accounts for the clinical overlap of these blistering diseases of the skin, and how the unraveling of the molecular pathophysiology of pemphigus provided the clues that were necessary to determine the mechanism of the formation of blisters in bullous impetigo and the staphylococcal scalded-skin syndrome. We also discuss how this new understanding of the pathophysiology of pemphigus could improve the diagnosis and treatment of this potentially life-threatening disease.