The disruption in cellular adhesion observed in bullous impetigo is caused by an exfoliative toxin related to Staphylococcus aureus.
Staphylococcus aureus, or "Staphylococcus", is a type of bacterium found on the skin, nose, armpits, groin, and other areas of humans. These bacteria are not always harmful, but under the right circumstances they can make you sick. Staphylococcus aureus is a major cause of skin and soft tissue infections, including abscesses, boils, and cellulitis (red, swollen, painful, and hot skin). S. Staphylococcus aureus can also cause more serious infections, such as pneumonia, bloodstream infections, endocarditis (infection of the lining of the heart chambers and valves), and bone and joint infections.
Staphylococcus aureus is transmitted through contact with infected blood or body fluids, most commonly through contaminated hands.
Bullous impetigo begins as small vesicles that grow into flaccid blisters. Exfoliating toxin produced by Staphylococcus aureus causes loss of epidermal cell adhesion. The blisters contain clear or yellow fluid and eventually become purulent or black. Surrounding erythema and edema are usually absent. When the blister ruptures, it leaves an erythematous base with a scaly border.
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