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| • | “toxin mediated erythema” = more accurate because of clinical variations (though most cases are recurrent with a propensity for perineal involvement) |
| • | also get erythema and swelling of hands and feet |
| • | systemic signs are absent vs. toxic shock syndrome (such as fever, hypotension) |
| • | oral mucosal changes such as strawberry tongue, erythema, edema, and convalescent desquamation of hands and feet |
| • | occurring abruptly (24 to 48 hours) after a bacterial pharyngitis |
| • | can usually culture toxin producing bacteria from pharynx |
summary:
| • | think of as a "skin only" toxin mediated erythema (or a "skin only" adult Kawasaki disease) |
| • | same toxin (TSST-1) as Kawasaki disease, RED syndrome, and toxic shock syndrome |
| • | the host probably determines the phenotype of the disease |
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