Staphylococcal Scalded Skin Syndrome

Staphylococcal scalded skin syndrome (SSSS), also known as Ritter disease or pemphigus neonatorum, is a dangerous cutaneous infection caused by certain exotoxin-producing strains of species (see . Staphylococcal Scalded Skin Syndrome). The condition typically presents with superficial skin blistering and denudation and affects children more often than adults. In adults, SSSS is often associated with renal dysfunction or immunocompromise. Skin desquamation is typically caused by exotoxins from a distant location rather than a local infection spreading through the bloodstream. In the pediatric population, SSSS can present as early as 48 hours after birth and occurs less frequently in children older than 6. Staphylococcal scalded skin syndrome is primarily diagnosed clinically, with diagnostic evaluation aimed at detecting bacteremia, differentiating it from similar conditions such as bullous impetigo, and guiding appropriate treatment. Therapy includes antibiotics, specifically penicillinase-resistant penicillins, supportive care, and monitoring for possible sequelae, including hypothermia, hemodynamic instability, and relapse.