Abstract: Objective To explore a reliable method to differentiate staphylococcal scaled skin syndrome (SSSS)from toxic epidermal necrolysis(TEN).Methods Clinical manifestations and management were compared between 12 patients with SSSS and 6 patients with TEN.Blister roofs were obtained from all the patients,then subjected to histological section and HE staining.Results Histopathologically,blister roofs in SSSS were composed of stratum comeum and vestiges of stratum granulosum without any other strata involved.On the other hand,all epidermal strata were included in the blister roof of TEN with apparent eosinophilic necrosis of keratinocytes in the epidermis.Significant difference was observed between SSSS and TEN cases in the histopathological findings of blister roof,and all the histopathological diagnosis was consistent with clinical diagnosis of these patients.Conclusion Our results suggest that histopathological examination of blister roofs may be regarded as a reliable method to differentiate SSSS from TEN.

Key words: Staphylococcal scalded skin syndrome, Epidermal necrolysis,toxic, Epidermis