Staphylococcal scalded skin syndrome (SSSS) also is known as Ritter von Ritterschein disease in newborns. Staphylococcal scalded skin syndrome is a response to a staphylococcal infection and is characterized by peeling skin. SSSS is caused by the release of two exotoxins (epidermolytic toxins A and B) from toxigenic strains of the bacteria Staphylococcus aureus. SSSS occurs mostly in children younger than 5 years, particularly neonates (newborn babies). Lifelong protective antibodies against staphylococcal exotoxins are usually acquired during childhood which makes SSSS much less common in older children and adults. Lack of specific immunity to the toxins and an immature renal clearance system (toxins are primarily cleared from the body through the kidneys) make neonates the most at risk.
Adults with SSSS are most often immunocompromised or have renal failure.The symptoms of staphylococcal scalded skin syndrome may resemble other skin conditions.. The child may have no energy, and may have a fever. Within 24-48 hours fluid-filled blisters form. These rupture easily, leaving an area that looks like a burn. The skin becomes sensitive and uncomfortable even before the rash is fully visible. The rash starts out as bright red patches around the original area of crusting. Blisters may appear, and the skin may look wrinkled. Rash spreads to other parts of the body including the arms, legs and trunk. In newborns, lesions are often found in the diaper area or around the umbilical cord. Staphylococcus aureus is also commonly found in infections of the throat, ears and eyes.
Treatment usually requires ,as intravenous antibiotics are generally necessary to eradicate the staphylococcal infection. A penicillinase-resistant, anti-staphylococcal antibiotic such as flucloxacillin is used. Avoid the development of dehydration. As always, good hygiene can prevent the passage of the causative bacteria between people. In the event of an outbreak in a newborn nursery, members of the staff should have nasal smears taken to identify an adult who may be unknowingly carrying the bacteria and passing it on to the babies. Topical wound care should begin with saline, followed by topical antibiotic ointment. Laser treatment has also been used. In severe cases, cutting out the involved area followed by skin grafting may be necessary.
Staphylococcal Scalded Skin Syndrome Treatment and Prevention Tips
1. An anti-inflammatory drug, may be given by mouth.
2. A penicillinase-resistant, anti-staphylococcal antibiotic such as flucloxacillin is used.
3. Laser treatment has also been used.
4. In severe cases, cutting out the involved area followed by skin grafting may be necessary.
5. Good hygiene can prevent the passage of the causative bacteria between people
