Pdf use of skin substitute dressings in the treatment of. Staphylococcal scalded skin syndrome images dermnet nz. This condition generally affects children pdf staphylococcal scalded skin syndrome. Staphylococcal scalded skin syndrome ssss is a bacterial. It is associated with the presence of staphylococcal strains producing. Treatment of ssss usually requires hospitalisation, as intravenous antibiotics are generally necessary to eradicate the staphylococcal infection. The disease can be lifethreatening and needs treatment. Most individuals respond to oral or intravenous antibiotic therapy, specifically penicillaseresistance antibiotics with activity against staphylococcal infections.
Oct 27, 2017 staphylococcal scalded skin syndrome ssss is a potentially life. Bacterial skin infection is a relatively frequent condition in paediatric population. Successful results are achieved in this case due to timely and correct management. Staphylococcal scalded skin syndrome archives of disease in. It is important to make a diagnosis early, particularly to differentiate it from ten, which has a different management and much greater. Dermatologic manifestations of staphylococcal scalded skin. Symptoms are widespread bullae with epidermal sloughing. Staphylococcal scalded skin syndrome is a rare dermatologic disorder associated with staphylococcal infection. This is accompanied by systemic symptoms, such as a fever of about 38c, irritability, and poor appetite. Jun 08, 2015 staphylococcal scalded skin syndrome ssss or acute staphylococcal epidermolysis is an exfoliative skin disease and a toxin mediated staphylococcal infections affecting mostly neonates and adolescents and it is rare in adults 1, 2.
Apr 03, 2020 staphylococcal scalded skin syndrome ssss is caused by an exfoliative toxin produced by roughly 5% of staphylococcus aureus. Staphylococcal scalded skin syndrome archives of disease. It is the bacterial toxin that causes the outer layer of skin to become detached and then peel and crust. Key points about staphylococcal scalded skin syndrome in children. Treatment is antistaphylococcal antibiotics and local care. Some therapeutic options are widely used without thorough research bases. It is the bacterial toxin that causes the outer layer of. Staphylococcal scalded skin syndrome dermatologic disorders.
Ssss is most common in infants and children, but can also affect adults with a depressed immune system or problems with kidney function. Staphylococcal scalded skin syndrome ssss, or ritter disease, is a potentially fatal pediatric emergency, especially in newborns. 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. 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 ssss is an illness characterised by red blistering skin that looks like a burn or scald, hence its name staphylococcal scalded skin syndrome. A unique case of a pregnant woman with chronic atopic dermatitis who developed ssss is presented. Staphylococcal scalded skin syndrome bmj case reports. Staphylococcal scalded skin syndrome knowledge for. 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. Staphylococcal scalded skin syndrome is a bacterial infection. Albert einstein college of medicine, bronx, ny staphylococcal scalded skin syndrome ssss is the most severe manifestation in the spectrum of staphylococcus aureus exotoxinmediated disease in skin. Recent developments in staphylococcal scalded skin syndrome. The disorder is also known as ritter disease, bullous impetigo, neonatal pemphigus, or staphylococcal scarlet fever.
Staphylococcal scalded skin syndrome ssss treatment. Apr 05, 2018 staphylococcal scalded skin syndrome is a pathological condition usually found in children and immune compromised individuals caused due to bacteria staphylococcus aureus. The skin then resembles a scald or burn, which is why the condition is called the staphylococcal scalded skin syndrome. Medical definition of staphylococcal scalded skin syndrome. Staphylococcal scalded skin syndrome is a pathological condition usually found in children and immune compromised individuals caused due to bacteria staphylococcus aureus. Staphylococcal scalded skin syndrome differential diagnosis there are a number of skin disorders which show signs and symptoms similar to that of ssss. Outbreaks of nosocomial staphylococcal scalded skin syndrome ssss in infants have been welldescribed associated with the well baby nursery or delivery room. Ssss is caused by the exfoliative toxins epidermolytic toxins a and b of some strains of staphylococcus aureus. Staphylococcal scalded skin syndrome information for parents. Molecular epidemiology of staphylococcal scalded skin. Home topics az staphylococcal scalded skin syndrome images. The latest treatment options are used and described.
Staphylococcal scalded skin syndrome ssss or acute staphylococcal epidermolysis is an exfoliative skin disease and a toxin mediated staphylococcal infections affecting mostly neonates and adolescents and it is rare in adults 1, 2. We describe two cases of ssss in very low birth weight infants in a neonatal intensive care unit nicu and the success of infection control strategies used to prevent an outbreak. It is rare in adults, but when diagnosed, it often is associated with renal failure, immunodeficiency, or overwhelming staphylococcal infection. In children, the disease usually starts with fussiness, tiredness, and a fever. The purpose of this article is to familiarize physicians with the evaluation, diagnosis, and treatment of ssss. Staphylococcal scalded skin syndrome nord national. It causes the skin to become red, sore and blistered. Staphylococcal scalded skin syndrome tends to appear abruptly with diffuse erythema and fever. Staphylococcal scalded skin syndrome is caused predominantly by phage group 2 staphylococci, particularly strains 71 and 55, which are present at localized sites of infection. Staphylococcal scalded skin syndrome ssss is a potentially life. Staphylococcal scalded skin syndrome is an infection of the skin. Currently, the incidence of this disease is increasing in all ages. Staphylococcal scalded skin syndrome is the severe condition caused by exfoliative staphylococcal toxins and is characterized by systemic signs and symptoms and generalized involvement of the skin fig. Staphylococcal scalded skin syndrome american academy of.
The staphylococcal scalded skin syndrome or the ritters disease1 is a staphylococcus aureus skin infection that typically has two periods of incidence. After the initial prodrome of conjunctivitis or sore throat, a tender rash that is erythematous, diffuse, and usually most apparent in the flexural areas appears. It is important to make a diagnosis early, particularly to differentiate it from ten, which has a. The staphylococcal scalded skin syndrome may be a consequence of cellulitis, another skin infection. Apr 25, 2017 staphylococcal scalded skin syndrome ssss is a toxinmediated type of exfoliative dermatitis. It begins with reddening and blistering around the mouth, nostrils, and periocular area. It is a rare condition, which tends to occur in younger children. Staphylococcal infections american academy of pediatrics. In this infection, skin surface of large parts of body gets peeled off and looks like burned skin by hot liquid. May 20, 2014 staphylococcal scalded skin syndrome tends to appear abruptly with diffuse erythema and fever. The staphylococcal scalded skin syndrome is among the bacterial skin infections that cause blistering and skin exfoliation.
It causes a reddening and blistering of the skin that gives it a scalded or burned look. This condition is characterized by blistering in the skin surface which more or less looks like a burn and that is what gives it the name of staphylococcal scalded skin syndrome. Staphylococcal scalded skin syndrome describes a spectrum of superficial blistering skin disorders caused by the exfoliative toxins of staphylococcus aureus. Use of skin substitute dressings in the treatment of staphylococcal scalded skin syndrome in neonates and young infants. It is a disease primarily affecting infants and young children,2 but cases. The first step in treating any disease is a proper diagnosis. 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. Your childs healthcare provider will figure out the best treatment plan for your child based on.
Ssss is caused by the release of two exotoxins epidermolytic toxins a and b from toxigenic strains of the bacteria staphylococcus aureus. Staphylococcal scalded skin syndrome knowledge for medical. Staphylococcal scalded skin syndrome ssss is a superficial blistering disorder mediated by staphylococcus aureus exfoliative toxins. Staphylococcal scalded skin syndrome ssss is the medical term used to define a skin condition induced by the exfoliative toxins produced by staphylococcus aureus. Scalded skin syndrome is a skin reaction to a bacterial infection called staphylococcus aureus. Staphylococcal scalded skin syndrome is an acute epidermolysis caused by a staphylococcal toxin. Staphylococcal scalded skin syndrome affects males and females in equal numbers. Staphylococcal scalded skin syndrome ssss is an uncommon, superficial blistering skin condition, characterised by widespread erythema and exfoliation, mainly occuring in children under five years of age, although older children and adults can be affected. Previous terms for ssss in newborn infants include ritters disease and pemphigus neonatorum.
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. Staphylococcalscalded skin syndrome ssss, also known as ritter disease, is a potentially lifethreatening disorder and a pediatric emergency. What is staphylococcal scalded skin syndromecauses. Scalded skin syndrome is diagnosed with a biopsy and a bacterial culture. Staphylococcal scalded skin syndrome british association of. Staphylococcal scalded skin syndrome ssss is a response to a staphylococcus staph infection. In its severe form, the exfoliation can spread to cover the entire body surface area. Staphylococcal scalded skin syndrome medical definition. To guide pch ed staff with the assessment and management of staphylococcal scalded skin syndrome in children. Staphylococcal scalded skin syndrome perth childrens hospital. Staphylococcal scalded skin syndrome ssss is a superficial blistering disorder mediated by staphylococcus aureus exfoliative toxins ets. Staphylococcal scalded skin syndrome linkedin slideshare.
This condition generally affects children aug 31, 2016 staphylococcal scalded skin syndrome ssss is counted as one of the major skin infections. Dec 01, 2017 staphylococcal scalded skin syndrome ssss is a serious skin infection caused by the bacterium staphylococcus aureus. Staphylococcal scalded skin syndrome causes, symptoms. Toxinmediated staphylococcal syndromes comprise a group of blistering skin diseases, ranging in severity from localized bullous impetigo to staphylococcal scalded skin syndrome, in which superficial blistering and exfoliation follow widespread pai. S aureus is the most common cause of pyogenic infection of the skin. Staphylococcal scalded skin syndrome johns hopkins medicine.
A penicillinaseresistant, antistaphylococcal antibiotic such as flucloxacillin is used. What is staphylococcal scalded skin syndromecausessymptoms. These blisters have the appearance of a scald or a burn, hence its name. What is the treatment of staphylococcal scalded skin syndrome. This case report highlights staphylococcal scalded skin syndrome and its treatment, and future challenges. Staphylococcal scalded skin syndrome in pregnancy mdedge. This bacterium produces an exfoliative toxin that causes the outer layers of. Staphylococcal scaldedskin syndrome ssss occurs most frequently in infants and children up to age 6. The disease presents with the widespread formation of fluidfilled blisters that are thin walled and easily ruptured, and the patient can be positive for nikolskys sign. The use of ringer solution to to balance the fluid loss, followed by maintainence therapy with an objective to maintain the fluid loss from. What is the pathogenesis of staphylococcal scalded skin.
Other antibiotics include nafcillin, oxacillin, cephalosporin and clindamycin. Early diagnosis and treatment is imperative to reduce the morbidity and mortality of this condition. May 02, 20 staphylococcal scalded skin syndrome differential diagnosis there are a number of skin disorders which show signs and symptoms similar to that of ssss. Dec 01, 2005 s aureus is the most common cause of pyogenic infection of the skin.
Hence, while diagnosing ssss, it is essential to differentiate it from such similar conditions in order to facilitate the development of an optimum treatment plan. 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. As the syndrome evolves, an initial infection occurs, commonly at a. Foci of infection include the nasopharynx and, less commonly, the umbilicus, urinary tract, a superficial abrasion, conjunctivae, and blood. Staphylococcal scalded skin syndrome ssss in children. It is usually preceded by a mucocutaneous staphylococcal infection, such as pharyngitis or bullous impetigo, though this preceding infection may. Staphylococcal scalded skin syndrome in a 4yearold child. The incidence, which has doubled in the last decade based on national hospitalization data, is estimated to be between. Staphylococcal scalded skin syndrome ssss is counted as one of the major skin infections. Mar 28, 2014 staphylococcal scalded skin syndrome is caused predominantly by phage group 2 staphylococci, particularly strains 71 and 55, which are present at localized sites of infection. It is usually preceded by a mucocutaneous staphylococcal infection, such as pharyngitis or bullous impetigo, though this preceding infection may go unnoticed by patients and other caregivers. 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. Epidemiology of staphylococcal scalded skin syndrome in u.
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