Editor,—In their recent review article on staphylococcal scalded skin syndrome, Ladhani and Evans provide a detailed and comprehensive review of the physiochemical properties of the staphylococcal exfoliative toxins and discuss their role as proteolytic agents in skin pathogenesis.1 However, the superantigenic properties of these toxins2 were not mentioned and the similarities with other desquamating conditions in childhood were overlooked. Superantigens bypass conventional antigen processing and recognition by directly binding to class II major histocompatibility molecules on the surface of antigen presenting cells. They induce massive polyclonal stimulation of T lymphocytes causing proliferation and …