Scalded skin syndrome

Skin | Dermatology | Scalded skin syndrome (Disease)


Staphylococcal scalded skin syndrome (SSSS) is a disease that usually affects infants and young children who lack the antibodies to Staphylococcus aureus toxins that adults have.

Causes and Risk factors

It is caused by bacterial infection by group II S aureus that produces toxins that cause exfoliation, bullae (blister) formation and redness of skin. In children mortality is low, but can be high in adults, who will usually have a serious underlying disease that makes them susceptible to infection.

White blood count (WBC) may be elevated; however, often WBC is normal. Erythrocyte sedimentation rate (ESR) frequently is elevated. Electrolytes and renal function should be followed closely in severe cases where fluid losses and dehydration via denuded skin are a concern.

Diagnosis and Treatment

A polymerase chain reaction (PCR) serum test for the toxin is available.

Treatment usually requires hospitalisation, as intravenous antibiotics are generally necessary to eradicate the staphylococcal infection. A penicillinase-resistant, anti-staphylococcal antibiotic such as flucloxacillin is used. Depending on response to treatment, oral antibiotics can be substituted within several days. The patient may be discharged from hospital to continue treatment at home.

SSSS usually follows a benign course when diagnosed and treated appropriately. However, if left untreated or treatment is unsuccessful, severe infections such as sepsis, cellulitis, and pneumonia may develop. Death can follow severe infection. ...