What Causes it?



The organism that causes SSSS is called Group II Staphylococcus aureus. Factors that may increase a person's risk of developing the disorder include impaired immunity and kidney function. Both risk factors are present to some extent in normal newborns because their immune system and kidneys are not fully developed.

What are its Symptoms?

An upper respiratory infection, possibly accompanied by itchy conjunctivitis, may precede development of SSSS. Skin changes pass through three stages:

• Erythema: Redness becomes visible, usually around the mouth and other orifices, and may spread in widening circles over the entire body surface. The skin becomes tender; Nikolsky's sign (sloughing of the skin when friction is applied) may appear.

• Exfoliation (24 to 48 hours later): In the more common, localized form of this disease, superficial erosions and minimal crusting occur, generally around orifices, and may spread to exposed skin areas. In the more severe forms, large, flaccid, fluid-filled blisters erupt and may spread over extensive areas of the body. These blisters eventually rupture, revealing sections of denuded skin.

• Desquamation: In this final stage, affected areas dry up and powdery scales form. Normal skin replaces these scales in 5 to 7 days.

How is it Diagnosed?

To diagnose SSSS, the doctor must carefully observe the disorder's three-stage progression. Microscopic examination of peeled skin may help to distinguish SSSS from other disorders. Isolation of the causative organism in cultures of skin lesions confirms the diagnosis.

How is it Treated?

Treatment includes systemic antibiotics - usually penicillinase­resistant penicillin - to treat the underlying infection as well as measures to maintain fluid and electrolyte balance. Complications are rare and residual scars are unlikely.