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Scalded skin syndrome
Ritter disease; Staphylococcal scalded skin syndrome (SSS)
Scalded skin syndrome is a skin infection caused by bacteria in which the skin becomes damaged and sheds.
Causes
Scalded skin syndrome (SSS) is caused by infection with certain strains of Staphylococcus bacteria. The bacteria produce a toxin that causes the skin damage. The damage creates blisters, as if the skin were scalded. These blisters can occur;at areas of the skin away from the initial site.
SSS is found most commonly in infants and children under the age of 5.
Symptoms
Symptoms may include any of the following:
- Blisters
- Fever
- Large areas of skin peel or fall away (exfoliation or desquamation)
- Painful skin
-
Redness of the skin (
erythema
), which spreads to cover most of the body
Erythema
Rashes involve changes in the color, feeling or texture of your skin.
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Skin slips off with gentle pressure, leaving wet red areas (
Nikolsky sign
)
Nikolsky sign
Nikolsky sign is a skin finding in which the top layers of the skin slip away from the lower layers when slightly rubbed.
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Exams and Tests
The health care provider will perform a physical exam and look at the skin. The exam may show that the skin slips off when it is rubbed (positive Nikolsky sign).
Tests may include:
-
Complete blood count (
CBC
)
CBC
A complete blood count (CBC) test measures the following:The number of red blood cells (RBC count)The number of white blood cells (WBC count)The tota...
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Cultures of the
skin
,
throat and nose
, and
blood
Skin
A skin or nail culture is a laboratory test to look for and identify germs that cause problems with the skin or nails. It is called a mucosal culture...
Read Article Now Book Mark ArticleThroat and nose
Nasopharyngeal culture is a test that examines a sample of secretions from the uppermost part of the throat, behind the nose, to detect organisms tha...
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A blood culture is a laboratory test to check for bacteria or other germs in a blood sample.
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Electrolyte
test
Electrolyte
Electrolytes are minerals in your blood and other body fluids that carry an electric charge. Electrolytes affect how your body functions in many ways...
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Skin biopsy
(in rare cases)
Skin biopsy
A skin lesion biopsy is when a small amount of skin is removed so it can be examined. The skin is tested to look for skin conditions or diseases. A...
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Treatment
Antibiotics are given by mouth or through a vein (intravenously; IV) to help fight the infection. IV fluids are also given to prevent dehydration. Much of the body's fluid is lost through open skin.
Moist compresses to the skin may improve comfort. You can apply a moisturizing ointment to keep the skin moist. Healing begins about 10 days after treatment.
Outlook (Prognosis)
A full recovery is expected.
Possible Complications
Complications that may result include:
-
Abnormal level of fluids in the body causing
dehydration
or
electrolyte
imbalance
Dehydration
Dehydration occurs when your body does not have as much water and fluids as it should. Dehydration can be mild, moderate, or severe, based on how muc...
Read Article Now Book Mark ArticleElectrolyte
Electrolytes are minerals in your blood and other body fluids that carry an electric charge. Electrolytes affect how your body functions in many ways...
Read Article Now Book Mark Article - Poor temperature control (in young infants)
-
Severe bloodstream infection (
septicemia
)
Septicemia
Septicemia is bacteria in the blood (bacteremia) that often occurs with severe infections. Also called sepsis, septicemia is a serious, life-threate...
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Spread to deeper skin infection (
cellulitis
)
Cellulitis
Cellulitis is a common skin infection caused by bacteria. It affects the middle layer of the skin (dermis) and the tissues below. Sometimes, muscle...
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When to Contact a Medical Professional
Call your provider or go to the emergency room if you have symptoms of this disorder.
Prevention
The disorder may not be preventable. Treating any staphylococcus infection quickly can help.
References
Koch D, Taibjee SM. Staphylococcal scalded skin syndrome. In: Lebwohl MG, Heymann WR, Berth-Jones J, Coulson I, eds. Treatment of Skin Disease: Comprehensive Therapeutic Strategies . 4th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 223.
Paller AS, Mancini AJ. Bacterial, mycobacterial, and protozoal infections of the skin. In: Paller AS, Mancini AJ, eds. Hurwitz Clinical Pediatric Dermatology . 5th ed. Philadelphia, PA: Elsevier; 2016:chap 14.
Review Date: 12/10/2015
Reviewed By: Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
