35 下列關於Staphylococcal scalded skin syndrome（SSSS）之敘述，何者錯誤？

Nikosky’s sign常呈現陽性 常合併化膿性結膜炎（purulent conjunctivitis）

水疱液常培養出Staphylococcus aureus 必須使用全身性抗生素治療

Background

Staphylococcal scalded skin syndrome (SSSS), also known as Ritter von Ritterschein disease (in newborns), Ritter disease, and staphylococcal epidermal necrolysis, encompasses a spectrum of superficial blistering skin disorders caused by the exfoliative toxins of some strains of Staphylococcus aureus.

It is a syndrome of acute exfoliation of the skin typically following an erythematous cellulitis. Severity of staphylococcal scalded skin syndrome varies from a few blisters localized to the site of infection to a severe exfoliation affecting almost the entire body.

it is caused by toxin by the s. aureus. spread via hematogenous route. involve in intraepidermal layer. thus at the site of the skin lesion, usually no bacteria is cultured as oppose to bulous impetigo.