Staphylococcal scalded skin syndrome ssss or acute staphylococcal epidermolysis is an exfoliative skin disease and a toxin mediated staphylococcal infections affecting mostly neonates and adolescents and it is rare in adults 1, 2. It is associated with the presence of staphylococcal strains producing. It tells you what it is, what causes it, what treatment is available, and where you can find out more about it. Staphylococcal scalded skin syndrome ssss is a potentially serious acute skin condition caused by the exfoliative toxins of staphylococcus aureus and typically affects infants and young children. Jun 08, 2015 staphylococcal scalded skin syndrome ssss or acute staphylococcal epidermolysis is an exfoliative skin disease and a toxin mediated staphylococcal infections affecting mostly neonates and adolescents and it is rare in adults 1, 2. Pediatric dermatology emergencies mdedge dermatology. Staphylococcal scalded skin syndrome ssss treatment. Staphylococcal scalded skin syndrome ssss is an uncommon, superficial blistering skin condition, characterised by widespread erythema and exfoliation, mainly occuring in children under five years of age, although older children and adults can be affected. It is usually preceded by a mucocutaneous staphylococcal infection, such as pharyngitis or bullous impetigo, though this preceding infection may go unnoticed by patients and other caregivers. It is a disease primarily affecting infants and young children,2 but cases. What is staphylococcal scalded skin syndromecausessymptoms. Staphylococcal scalded skin syndrome ssss is a toxinmediated type of exfoliative dermatitis. Staphylococcal scalded skin syndrome ssss is counted as one of the major skin infections. Apr 25, 2017 staphylococcal scalded skin syndrome ssss is a toxinmediated type of exfoliative dermatitis.
Staphylococcal scalded skin syndrome describes a spectrum of superficial blistering skin disorders caused by the exfoliative toxins of staphylococcus aureus. Most individuals respond to oral or intravenous antibiotic therapy, specifically penicillaseresistance antibiotics with activity against staphylococcal infections. Until recently, the scalded skin syndrome, in association with s. Staphylococcal scalded skin syndrome in a 4yearold child. Staphylococcal scalded skin syndrome is a bacterial infection. Staphylococcal scalded skin syndrome ssss is a response to a staphylococcus staph infection. It is rare in adults, but when diagnosed, it often is associated with renal failure, immunodeficiency, or overwhelming staphylococcal infection. Staphylococcal scalded skin syndrome medical definition. A biopsy involves looking at a piece of skin under a microscope, and a bacterial culture involves growing the bacteria in a petri dish both methods are used to determine whats causing the medical condition source. Medical definition of staphylococcal scalded skin syndrome. Staphylococcal scalded skin syndrome ssss is a superficial blistering disorder mediated by staphylococcus aureus exfoliative toxins ets. Outbreaks of nosocomial staphylococcal scalded skin syndrome ssss in infants have been welldescribed associated with the well baby nursery or delivery room.
The staphylococcal scalded skin syndrome or the ritters disease1 is a staphylococcus aureus skin infection that typically has two periods of incidence. Staphylococcal scalded skin syndrome is a rare dermatologic disorder associated with staphylococcal infection. Other antibiotics include nafcillin, oxacillin, cephalosporin and clindamycin. What is the pathogenesis of staphylococcal scalded skin. Molecular epidemiology of staphylococcal scalded skin. Staphylococcal scalded skin syndrome is an acute epidermolysis caused by a staphylococcal toxin. In this infection, skin surface of large parts of body gets peeled off and looks like burned skin by hot liquid. Staphylococcal scalded skin syndrome ssss is an illness characterised by red blistering skin that looks like a burn or scald, hence its name staphylococcal scalded skin syndrome. Pdf use of skin substitute dressings in the treatment of. Staphylococcal scalded skin syndrome british association of. Epidemiology of staphylococcal scalded skin syndrome in u.
Previous terms for ssss in newborn infants include ritters disease and pemphigus neonatorum. Staphylococcal scalded skin syndrome knowledge for. Foci of infection include the nasopharynx and, less commonly, the umbilicus, urinary tract, a superficial abrasion, conjunctivae, and blood. Early diagnosis and treatment is imperative to reduce the morbidity and mortality of this condition. The use of ringer solution to to balance the fluid loss, followed by maintainence therapy with an objective to maintain the fluid loss from. Staphylococcal scalded skin syndrome archives of disease.
It is important to make a diagnosis early, particularly to differentiate it from ten, which has a. Ssss is caused by the exfoliative toxins epidermolytic toxins a and b of some strains of staphylococcus aureus. May 02, 20 staphylococcal scalded skin syndrome differential diagnosis there are a number of skin disorders which show signs and symptoms similar to that of ssss. Hence, while diagnosing ssss, it is essential to differentiate it from such similar conditions in order to facilitate the development of an optimum treatment plan. Staphylococcal scalded skin syndrome perth childrens hospital. Staphylococcal scalded skin syndrome ssss, or ritter disease, is a potentially fatal pediatric emergency, especially in newborns. This bacterium produces an exfoliative toxin that causes the outer layers of. Treatment is antistaphylococcal antibiotics and local care. Successful results are achieved in this case due to timely and correct management. In children, the disease usually starts with fussiness, tiredness, and a fever. Staphylococcal scalded skin syndrome knowledge for medical. It is the bacterial toxin that causes the outer layer of.
To guide pch ed staff with the assessment and management of staphylococcal scalded skin syndrome in children. Scalded skin syndrome is a skin reaction to a bacterial infection called staphylococcus aureus. Staphylococcal scalded skin syndrome information for parents what is scalded skin syndrome. Dec 01, 2017 staphylococcal scalded skin syndrome ssss is a serious skin infection caused by the bacterium staphylococcus aureus. Staphylococcal scalded skin syndrome ssss is a potentially life.
Ssss is most common in infants and children, but can also affect adults with a depressed immune system or problems with kidney function. The purpose of this article is to familiarize physicians with the evaluation, diagnosis, and treatment of ssss. A penicillinaseresistant, antistaphylococcal antibiotic such as flucloxacillin is used. Staphylococcalscalded skin syndrome ssss, also known as ritter disease, is a potentially lifethreatening disorder and a pediatric emergency. The latest treatment options are used and described. Bacterial skin infection is a relatively frequent condition in paediatric population.
Apr 03, 2020 staphylococcal scalded skin syndrome ssss is caused by an exfoliative toxin produced by roughly 5% of staphylococcus aureus. Staphylococcal scalded skin syndrome tends to appear abruptly with diffuse erythema and fever. Staphylococcal scalded skin syndrome ssss is a bacterial toxinmediated skin disorder that primarily affects young children but can also occur in older children and adults. Ritters disease of the newborn is the most severe form of ssss, with similar signs and symptoms. May 20, 2014 staphylococcal scalded skin syndrome tends to appear abruptly with diffuse erythema and fever. What is the treatment of staphylococcal scalded skin syndrome. Oct 27, 2017 staphylococcal scalded skin syndrome ssss is a potentially life. Staphylococcal scalded skin syndrome dermatologic disorders. Staphylococcal scalded skin syndrome information for parents. The staphylococcal scalded skin syndrome may be a consequence of cellulitis, another skin infection.
Staphylococcal scalded skin syndrome ssss is a superficial blistering disorder mediated by staphylococcus aureus exfoliative toxins. Staphylococcal scalded skin syndrome archives of disease in. This condition generally affects children aug 31, 2016 staphylococcal scalded skin syndrome ssss is counted as one of the major skin infections. These observations have now been confirmed and extended by a number of other laboratories 1, 35, 10. Recent developments in staphylococcal scalded skin syndrome. Staphylococcal scalded skin syndrome is the severe condition caused by exfoliative staphylococcal toxins and is characterized by systemic signs and symptoms and generalized involvement of the skin fig. Staphylococcal scalded skin syndrome is caused predominantly by phage group 2 staphylococci, particularly strains 71 and 55, which are present at localized sites of infection. Staphylococcal scalded skin syndrome is a pathological condition usually found in children and immune compromised individuals caused due to bacteria staphylococcus aureus. Staphylococcal scalded skin syndrome ssss is the clinical term used for a spectrum of blistering skin diseases induced by the exfoliative epidermolytic toxins et of staphylococcus aureus. Some therapeutic options are widely used without thorough research bases. Staphylococcal scalded skin syndrome is an infection of the skin. The disease can be lifethreatening and needs treatment. It is the bacterial toxin that causes the outer layer of skin to become detached and then peel and crust.
It causes a reddening and blistering of the skin that gives it a scalded or burned look. Key points about staphylococcal scalded skin syndrome in children. Epidemiological studies of ssss in france and germany. Staphylococcal scalded skin syndrome in pregnancy mdedge. Currently, the incidence of this disease is increasing in all ages.
This condition generally affects children pdf staphylococcal scalded skin syndrome. Staphylococcal infections american academy of pediatrics. These blisters have the appearance of a scald or a burn, hence its name. After the initial prodrome of conjunctivitis or sore throat, a tender rash that is erythematous, diffuse, and usually most apparent in the flexural areas appears. Staphylococcal scalded skin syndrome is caused by bacteria called staphylococcus aureus. The first step in treating any disease is a proper diagnosis. Staphylococcal scalded skin syndrome affects males and females in equal numbers. Staphylococcal scalded skin syndrome ssss is a bacterial. This is accompanied by systemic symptoms, such as a fever of about 38c, irritability, and poor appetite. A unique case of a pregnant woman with chronic atopic dermatitis who developed ssss is presented. Home topics az staphylococcal scalded skin syndrome images.
The skin then resembles a scald or burn, which is why the condition is called the staphylococcal scalded skin syndrome. Your childs healthcare provider will figure out the best treatment plan for your child based on. Staphylococcal scalded skin syndrome ssss in children. It is usually preceded by a mucocutaneous staphylococcal infection, such as pharyngitis or bullous impetigo, though this preceding infection may. The incidence, which has doubled in the last decade based on national hospitalization data, is estimated to be between. Toxinmediated staphylococcal syndromes comprise a group of blistering skin diseases, ranging in severity from localized bullous impetigo to staphylococcal scalded skin syndrome, in which superficial blistering and exfoliation follow widespread pai.
Although dukes identified it as a separate entity, it is thought not to be different from scarlet fever caused by staphylococcal exotoxin after keith powell proposed equating it with the condition currently known as staphylococcal scalded skin syndrome in 1979. Dermatologic manifestations of staphylococcal scalded skin. Staphylococcal scalded skin syndrome causes, symptoms. This condition is characterized by blistering in the skin surface which more or less looks like a burn and that is what gives it the name of staphylococcal scalded skin syndrome. It is important to make a diagnosis early, particularly to differentiate it from ten, which has a different management and much greater. Mar 28, 2014 staphylococcal scalded skin syndrome is caused predominantly by phage group 2 staphylococci, particularly strains 71 and 55, which are present at localized sites of infection.
It is a rare condition, which tends to occur in younger children. This case report highlights staphylococcal scalded skin syndrome and its treatment, and future challenges. The diagnosis can be confirmed by a skin biopsy specimen, which can be expedited by frozen section processing, as staphylococcal scalded skin syndrome should be distinguished from life threatening toxic epidermal necrolysis. Staphylococcal scalded skin syndrome johns hopkins medicine. Staphylococcal scalded skin syndrome linkedin slideshare.
In its severe form, the exfoliation can spread to cover the entire body surface area. S aureus is the most common cause of pyogenic infection of the skin. The disease presents with the widespread formation of fluidfilled blisters that are thin walled and easily ruptured, and the patient can be positive for nikolskys sign. We describe two cases of ssss in very low birth weight infants in a neonatal intensive care unit nicu and the success of infection control strategies used to prevent an outbreak. The disease is characterized by erythema and exfoliation and is mediated by exotoxins elaborated primarily by phage group ii s aureus. Staphylococcal scalded skin syndrome american academy of. As the syndrome evolves, an initial infection occurs, commonly at a. Use of skin substitute dressings in the treatment of staphylococcal scalded skin syndrome in neonates and young infants. Symptoms are widespread bullae with epidermal sloughing. Scalded skin syndrome is diagnosed with a biopsy and a bacterial culture. Dec 01, 2005 s aureus is the most common cause of pyogenic infection of the skin. When adequately treated, the prognosis is excellent.
What is staphylococcal scalded skin syndromecauses. Staphylococcal scalded skin syndrome differential diagnosis there are a number of skin disorders which show signs and symptoms similar to that of ssss. Staphylococcal scalded skin syndrome ssss is caused by an exfoliative toxin produced by roughly 5% of staphylococcus aureus. Apr 05, 2018 staphylococcal scalded skin syndrome is a pathological condition usually found in children and immune compromised individuals caused due to bacteria staphylococcus aureus. With early recognition and treatment, children should recover fully. The disorder is also known as ritter disease, bullous impetigo, neonatal pemphigus, or staphylococcal scarlet fever. It causes the skin to become red, sore and blistered. Treatment of ssss usually requires hospitalisation, as intravenous antibiotics are generally necessary to eradicate the staphylococcal infection. Staphylococcal scalded skin syndrome bmj case reports. Staphylococcal scalded skin syndrome nord national.
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