ReportStaphylococcal toxins in patients with psoriasis, atopic dermatitis, and erythroderma, and in healthy control subjects
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Patients
To investigate skin colonization with S aureus and its enterotoxin profile, we performed a prospective study in 25 patients with AD, 25 with PS, 6 with erythroderma, and in 25 healthy control subjects between January 2001 and March 2002 (Table I). For control purposes, S aureus strains isolated from 25 patients with skin infections and 9 patients with staphylococcal sepsis were investigated. Patients with S aureus skin infection had impetigo (n = 5), leg ulcer (n = 4), basal cell carcinoma (n = 3),
Results
S aureus was cultivated from lesional skin of 22 of 25 patients with AD and 15 of 25 patients with PS (Table I). Isolated strains were toxigenic in 44% for patient with AD and in 36% for patients with PS. The activity of disease in AD and PS according to the SCORAD or Psoriasis Area and Severity Index score, respectively, correlated significantly with an isolated toxigenic strain in both diseases (Fig 1, Fig 2). S aureus was further isolated in all 6 patients with erythroderma and in 2 of 25
S aureus in PS
When we analyzed the distribution of staphylococcal enterotoxins and their potential effect on disease activity, we found colonization of lesional skin with S aureus occurred in 60% of patients with PS, consistent with data that have already been reported in the literature.4, 17 In 60%, these strains were toxigenic. The toxin most often detected was SEB followed by SEC, SED, SEA/D, and SEB/C. Patients with enterotoxin-positive PS had a significantly (P = .001) higher Psoriasis Area and Severity
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Funding sources: None.
Conflicts of interest: None identified.