Summary Staphylococcal scalded skin syndrome (SSSS) is typically a clinical diagnosis,1 affecting primarily neonates and children. It is characterised by a diffuse skin disorder with tenderness, erythema, large wrinkled superficial blistering, and desquamation caused by the hematogenous dissemination of exotoxin-producing strains of staphylococcus aureus to the skin.4,10 Hospital admission is required for intravenous anti-staphylococcal antibiotic therapy and supportive care. The rarity of SSSS in adults is best explained by the presence of exotoxins neutralizing antibodies and renal elimination of the toxins.2 Two major risk factors are kidney failure and immunosuppression. Therefore, SSSS in adults warrants thorough evaluation.3 Mortality is also greater than 60% in adults, attributed to predisposing comorbid conditions.1,4 One of the mimickers of SSSS is toxic epidermal necrolysis (TEN). Here, we report a successful treatment of SSSS in an adult with recreational drug abuse and incidental liver cirrhosis possibly secondary to hepatitis C viral infection, after careful exclusion of TEN.
Staphylococcal Scalded Skin Syndrome ; Staphylococcal Infections ; Adult

OBJECTIVE: This study was done to determine whether Tualang honey could prevent the altered nociceptive behaviour, with its associated changes of oxidative stress markers and morphology of the spinal cord, among the offspring of prenatally stressed rats. METHODS: Pregnant rats were divided into three groups: control, stress, and stress treated with Tualang honey. The stress and stress treated with Tualang honey groups were subjected to restraint stress from day 11 of pregnancy until delivery. Ten week old male offspring (n = 9 from each group) were given formalin injection and their nociceptive behaviours were recorded. After 2 h, the rats were sacrificed, and their spinal cords were removed to assess oxidative stress activity and morphology. Nociceptive behaviour was analysed using repeated measures analysis of variance (ANOVA), while the levels of oxidative stress parameters and number of Nissl-stained neurons were analysed using a one-way ANOVA. RESULTS: This study demonstrated that prenatal stress was associated with increased nociceptive behaviour, changes in the oxidative stress parameters and morphology of the spinal cord of offspring exposed to prenatal stress; administration of Tualang honey reduced the alteration of these parameters. CONCLUSION This study provides a preliminary understanding of the beneficial effects of Tualang honey against the changes in oxidative stress and neuronal damage in the spinal cord of the offspring of prenatally stressed rats.

Introduction: Increased nociceptive responses were shown in the offspring of prenatally stressed rats. Reports have demonstrated the anti-nociceptive effects of Tualang honey in the rat offspring. The present study was done to determine whether the modulation of nociceptive behaviour by Tualang honey was mediated by modulating changes in the histology, oxidative stress parameters and N-methyl-D-aspartate (NMDA) receptors in the thalamus of the rat offspring. Methods: Eighteen Sprague Dawley pregnant rats were randomly assigned to control (C), stress (S) and stress-treated with Tualang honey (SH) groups. Stress was given in a form of restraint stress.Tualang honey was given to SH group from first day of pregnancy until delivery. Thirty-three adult male offspring were subjected to formalin test before they were sacrificed. Nociceptive behaviour score, number of neurons, level of oxidative stress parameters and NMDA receptors in the thalamus were analysed by using one-way ANOVA. Results: The study demonstrated a significant decrease in mean nociceptive behaviour score (p<0.05) with lower malondialdehyde (MDA, p<0.05) and higher superoxide dismutase SOD and catalase levels in the thalamus of SH group compared to S group (p<0.05). There was also increased Nissl positive neurons in the thalamus of SH group compared to S group. There was no significant difference in NMDA receptor level between S and SH groups. Conclusion: The modulation of nociceptive responses in the prenatally stressed rat offspring by Tualang honey was associated with improvement in oxidative stress parameters and histology of the thalamus in the rat offspring exposed to prenatal stress.