Staphylococcal scalded skin

Staphylococcal scalded skin syndrome (SSSS) is a bacterial toxin-mediated illness caused by exotoxins released from staphylococcus aureus. The exotoxins cause widespread erythema with superficial blistering and desquamation of the skin (with the appearance of a scald) due to destruction of desmosomes. In addition to the rash, children developed fever and irritability.

SSSS typically affects preschool aged children, infants and neonates, although immunocompromised older children and adults can also be at risk. It typically starts from an infection with an exotoxin-releasing S. aureus strain, such as impetigo.

Treatment is with intravenous antibiotics and supportive care, with intravenous fluids due to the potential for significant fluid loss through the skin and measures to minimise trauma to the skin. Children tend to recover within a few days.