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Acne Help (Home) > Rare Skin Disorders > Staphylococcal Scalded Skin Syndrome

Staphylococcal Scalded Skin Syndrome: Causes, Symptoms and Treatment

Staphylococcal scalded skin syndrome (SSSS) is an illness, caused by a type of bacteria, in which large sheets of skin may peel away. SSSS primarily strikes children under the age of five, particularly infants. Clusters of SSSS cases (epidemics) can occur in newborn nurseries, when staff in those nurseries accidentally passes the causative bacteria between patients. It can also strike other age groups who have weakened immune systems. Such immuno-compromised patients include those with kidney disease, people undergoing cancer chemotherapy, organ transplant patients, and individuals with acquired immunodeficiency syndrome (AIDS).

Cause of Staphylococcal Scalded Skin Syndrome

Scalded skin syndrome is caused by infection with certain strains of bacteria called staphylococcus. During the infection, the staphylococci produce a poison that is responsible for the skin damage. Onset of the illness may be heralded by fever and skin tenderness.

Symptoms of Staphylococcal Scalded Skin Syndrome

• Symptoms begin with an isolated, crusted infection that may look like impetigo.
• In newborns, the infection may appear in the diaper area or around the stump of the umbilical cord.
• In adults, the infection may begin anywhere.
• In all people with this disorder, scarlet-colored areas appear around the crusted area within a day of the beginning of infection.
• These areas may be painful. Then, other large areas of skin distant from the initial infection redden and develop blisters that break easily.
• The top layer of the skin then begins peeling off, often in large sheets, with even slight touching or gentle pushing.
• Within another 1 to 2 days, the entire skin surface may be involved, and the person becomes very ill with a fever, chills, and weakness.
• With the loss of the protective skin barrier, other bacteria and infective organisms can easily penetrate the body, causing what doctors call superinfections.

Also, critical amounts of fluid can be lost because of oozing and evaporation, resulting in dehydration.

Treatment for Staphylococcal Scalded Skin Syndrome

Treatment usually requires hospitalization, as intravenous antibiotics are generally necessary to eradicate the staphylococcal infection. A penicillinase-resistant, anti-staphylococcal antibiotic such as flucloxacillin is used. Depending on response to treatment, oral antibiotics can be substituted within several days. The patient may be discharged from hospital to continue treatment at home.

Other supportive treatments include:

• Paracetamol when necessary for fever and pain.
• Maintaining fluid and electrolyte intake.
• Skin care (the skin is often very fragile)

Although the outward signs of SSSS look bad, children generally recover well and healing is usually complete within 5-7 days of starting treatment.

Prevention

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.

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