Secondary Rash in Toxic-Shock Syndrome?

To the Editor: The toxic-shock syndrome (TSS) seen in tampon users and associated with the isolation of Staphylococcus aureus from the vagina is frequently accompanied by a diffuse erythematous macular rash. This rash usually disappears in 24 to 48 hours and is followed by desquamation of the skin on the hands and feet in one to two weeks. We have recently seen four patients fulfilling the criteria* for TSS, and in three of them a macular-papular morbilliform eruption occurred between the sixth and 10th days. In all three patients the primary rash had resolved before the occurrence of this secondary. . .