The production of staphylococcal exfoliative toxin a eta and toxin b etb, toxic shock syndrome toxin tsst1, and enterotoxins ae was analyzed in 60 staphylococcus aureus strains isolated from children with scalded skin syndrome 15 with generalized exfoliative syndrome, 28 with bullous impetigo, and 17 with staphylococcal scarlet fever. Scalded skin syndrome is a skin reaction to a bacterial infection called staphylococcus aureus. Staphylococcus aureus is the most common bacteria to infect the skin, eyes and nose. The diagnosis of staphylococcal scalded skin syndrome was reached on clinical grounds and culture report. Staphylococcal scalded skin syndrome describes a spectrum of superficial blistering skin disorders caused by the exfoliative toxins of staphylococcus aureus. Staphylococcal scalded skin syndrome bmj case reports. 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. Pdf staphylococcal scalded skin syndrome in adults. Dec 01, 2017 staphylococcal scalded skin syndrome ssss is a serious skin infection caused by the bacterium staphylococcus aureus. Staphylococcal scalded skin syndrome archives of disease in. 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 staphylococcal scalded skin syndrome ssss is the clinical term used for a spectrum of blistering skin diseases induced by the exfoliative. What is the pathogenesis of staphylococcal scalded skin.
This infection produces a toxin that can affect skin all over the body. Epidemiology of staphylococcal scalded skin syndrome in u. The disorder is also known as ritter disease, bullous impetigo, neonatal pemphigus, or staphylococcal scarlet fever. Staphylococcalscalded skin syndrome ssss, also known as ritter disease, is a potentially lifethreatening disorder and a pediatric emergency. Staphylococcal scalded skin syndrome ssss is a potentially life. Staphylococcal scalded skin syndrome ssss, also known as ritter disease, is a bacterial infection of the skin that usually begins in the oral or nasal.
It occurs most frequently in infants and children up to age 6. It is rare in adults, but when diagnosed, it often is associated with renal failure, immunodeficiency, or overwhelming staphylococcal infection. This is a staphylococcal toxinmediated exfoliative dermatitis that can result in major skin loss because of widespread splitting of the granular layer of the epidermis. Staphylococcal scalded skin syndrome tends to appear abruptly with diffuse erythema and fever.
Early diagnosis and treatment is imperative to reduce the morbidity and mortality of this condition. Staphylococcal scalded skin syndrome information for parents what is scalded skin syndrome. Staphylococcal scalded skin syndrome ssss is the most severe manifestation in the spectrum of staphylococcus aureus exotoxinmediated disease in skin. Staphylococcal infections american academy of pediatrics. Pdf use of skin substitute dressings in the treatment of. Bacterial skin infection is a relatively frequent condition in paediatric population. Staphylococcal scalded skin syndrome ssss in children. The first step in treating any disease is a proper diagnosis. Patients with the most severe staphylococcal scalded skin syndrome should be treated with intravenous nafcillin or oxacillin, 2 g every 4 to 6 hours for 10 to 14 days. Staphylococcal scalded skin syndrome microbiology society.
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 nord national. Dec 01, 2005 s aureus is the most common cause of pyogenic infection of the skin. Toxin involvement in staphylococcal scalded skin syndrome. The infection causes peeling skin over large parts of the body. Staphylococcusscalded skin syndrome staff lo cok us skawl did skin sin drome, also known as scalded skin syndrome, ssss, or ritters disease, is a skin infection caused by a bacteria called staphylococcus aureus. Staphylococcal scalded skin syndrome ssss is the clinical term used for a spectrum of blis tering skin diseases induced by the exfoliative.
The toxin causes loss of cell adhesion in the epidermis. This bacterium produces an exfoliative toxin that causes the outer layers of skin to blister and peel, as if theyve been doused with a hot liquid. What is staphylococcal scalded skin syndrome in children. It begins with reddening and blistering around the mouth, nostrils, and periocular area. This is accompanied by systemic symptoms, such as a fever of about 38c, irritability, and poor appetite. Recent developments in staphylococcal scalded skin syndrome. It is caused by exfoliative toxins of staphylococcus aureus in the epidermis. We present ssss in an extremely lowbirthweight elbw infant with recurrent and confirmed bacterial sepsis. Scalded skin syndrome is diagnosed with a biopsy and a bacterial culture. Use of skin substitute dressings in the treatment of staphylococcal scalded skin syndrome in neonates and young infants.
Staphylococcal scalded skin syndrome ssss is a toxin related epidermolytic disease that usually affects infants and children. In this infection, skin surface of large parts of body. Staphylococcus scalded skin syndrome ssss ritters disease. Staphylococcal scaldedskin syndrome ssss occurs most frequently in infants and children up to age 6. In staphylococcal scalded skin syndrome, there is an upper epidermal blister, whereas toxic epidermal necrolysis causes a dermalepidermal blister. 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. It primarily affects children staphylococcal toxin.
The disease can be lifethreatening and needs treatment. Staphylococcal scalded skin syndrome in pregnancy mdedge. Mar 28, 2014 staphylococcal scalded skin syndrome 1. In children, the disease usually starts with fussiness, tiredness, and a fever. To guide pch ed staff with the assessment and management of staphylococcal scalded skin syndrome in children. Etiology caused predominantly by phage group 2 staphylococci, particularly strains 71 and 55 found in nasopharynx and, less commonly, the umbilicus, urinary tract, a superficial abrasion, conjunctivae, and blood spreads hematogenously nelsons textbook of pediatrics. Staphylococcal scalded skin syndrome caused by exfoliative toxin bproducing methicillinresistant staphylococcus aureus.
Summary staphylococcal scalded skin syndrome ssss is a recognised clinical entity that affects primarily the very young and, in rare cases, the very old or the immunocompromised. As the syndrome evolves, an initial infection occurs, commonly at a. Staphylococcal scalded skin syndrome ssss is a bacterial toxinmediated skin disorder that primarily affects young children but can also. It is a rare condition, which tends to occur in younger children. Staphylococcal scalded skin syndrome ssss is a serious skin infection. This condition generally affects children staphylococcus aureus, causes blisters in skin surface and is known as staphylococcal scaldedskin syndrome. Aug 31, 2016 staphylococcal scalded skin syndrome ssss is counted as one of the major skin infections. Staphylococcal scalded skin syndrome information for parents. 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. Staphylococcal scalded skin syndrome is more common in newborns than in adults. Staphylococcal scalded skin syndrome ssss is caused by systemic effects of circulating exfoliative toxins released by phage ii strains of s. 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. Apr 03, 2020 staphylococcal scalded skin syndrome ssss is caused by an exfoliative toxin produced by roughly 5% of staphylococcus aureus. May 20, 2014 staphylococcal scalded skin syndrome is a potentially life.
Key points about staphylococcal scalded skin syndrome in children. Staphylococcal scalded skin syndrome ssss is counted as one of the major skin infections. This condition generally affects children skin infection is a relatively frequent condition in paediatric population. The incidence, which has doubled in the last decade based on national hospitalization data, is estimated to be between. Staphylococcal scalded skin syndrome in a preterm infant jpms. Staphylococcal scalded skin syndrome affects males and females in equal numbers. Ssss is caused by the release of two exotoxins epidermolytic toxins a and b from toxigenic strains of the bacteria staphylococcus aureus. Oct 27, 2017 staphylococcal scalded skin syndrome ssss is a potentially life. Pdf staphylococcal scalded skin syndrome researchgate. Staphylococcal scalded skin syndrome american academy of. Staphylococcal scalded skin syndrome knowledge for medical. The hematogenous spread of exfoliative toxins a eta or b etb produced by specific staphylococcus aureus strains causes a scaldlike eruption with disseminated bullous lesions 1, 2.
Staphylococcal scalded skin syndrome ssss is the medical term used to define a skin condition induced by the exfoliative toxins produced by staphylococcus aureus. Staphylococcal scalded skin syndrome is a bacterial infection. 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. Previous terms for ssss in newborn infants include ritters disease and pemphigus neonatorum. The staphylococcal scalded skin syndrome or the ritters disease 1 is a staphylococcus aureus skin infection that typically has two periods of incidence.
Staphylococcal scalded skin syndrome british association of. The staphylococcal scalded skin syndrome or the ritters disease1 is a staphylococcus aureus skin infection that typically has two periods of incidence. Mar 05, 2018 staphylococcal scalded skin syndrome ssss in premature infants is a rare condition. 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 a serious skin infection caused by the bacterium staphylococcus aureus. What causes the staphylococcal scalded skin syndrome. Staphylococcal scalded skin syndrome ssss is a superficial blistering disorder mediated by staphylococcus aureus exfoliative toxins. 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. This bacterium produces an exfoliative toxin that causes the outer layers of. It looks like the skin has been scalded or burned by hot liquid.
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