Eruptive furunculosis following the soak and smear regimen

The ‘soak and smear’ regimen is a highly effective method for localised topical therapy employed by dermatologists for widespread inflammatory skin conditions. The regimen involves application of topical medication under occlusion after soaking in water. Complications from this treatment method are rare. We present a case of multiple, generalised methicillin-resistant Staphylococcus aureus (MRSA)-positive furuncles arising in a patient as an unexpected consequence of therapy. The case highlights an unanticipated risk of a commonly employed treatment amid an epidemic of MRSA in the community.

[1]  M. Pittelkow,et al.  Wet dressing therapy in conjunction with topical corticosteroids is effective for rapid control of severe pediatric atopic dermatitis: experience with 218 patients over 30 years at Mayo Clinic. , 2012, Journal of the American Academy of Dermatology.

[2]  Tatsuo Yamamoto,et al.  Nosocomial outbreak of multidrug‐resistant USA300 methicillin‐resistant Staphylococcus aureus causing severe furuncles and carbuncles in Japan , 2011, The Journal of dermatology.

[3]  F. Vandenesch,et al.  Panton-Valentine Leukocidin-Positive Staphylococcus aureus Strains Are Associated with Follicular Skin Infections , 2011, Dermatology.

[4]  S. Giedrys-Kalemba,et al.  Association of Recurrent Furunculosis with Panton-Valentine Leukocidin and the Genetic Background of Staphylococcus aureus , 2010, Journal of Clinical Microbiology.

[5]  M. Davis,et al.  Wet dressings used with topical corticosteroids for pruritic dermatoses: A retrospective study. , 2009, Journal of the American Academy of Dermatology.

[6]  B. Thiers.  Invasive Methicillin-Resistant Staphylococcus aureus Infections in the United States , 2008 .

[7]  Roberta B Carey,et al.  Invasive methicillin-resistant Staphylococcus aureus infections in the United States. , 2007, JAMA.

[8]  R. Grimalt,et al.  Treatment of patients with atopic dermatitis using wet‐wrap dressings with diluted steroids and/or emollients. An expert panel's opinion and review of the literature , 2006, Journal of the European Academy of Dermatology and Venereology : JEADV.

[9]  W. James,et al.  Soak and smear: a standard technique revisited. , 2005, Archives of dermatology.

[10]  J. Kaneko,et al.  The association between Staphylococcus aureus strains carrying panton-valentine leukocidin genes and the development of deep-seated follicular infection. , 2005, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[11]  T. Domínguez.  It's not a spider bite, it's community-acquired methicillin-resistant Staphylococcus aureus. , 2004, The Journal of the American Board of Family Practice.

[12]  A. Wolkerstorfer,et al.  Efficacy and safety of wet‐wrap dressings in children with severe atopic dermatitis: influence of corticosteroid dilution , 2000, The British journal of dermatology.