Staphylococcal scalded skin syndrome
Staphylococcal scalded skin syndrome (SSSS) is a dermatological condition caused by Staphylococcus aureus. The disease presents with the widespread formation of fluid-filled blisters that are thin walled and easily ruptured. Staphylococcal scalded skin syndrome often includes a widespread painful erythroderma, often involving the face, diaper, and other intertriginous areas. Extensive areas of desquamation might be present. Crusting and fissuring around the mouth are seen in the early phase. Unlike toxic epidermal necrolysis, the mucous membranes does not be affected in the staphylococcal scalded skin syndrome. It is most common in children under 6 years.

The syndrome is induced by epidermolytic exotoxins (exfoliatin)A and B, which are released by S. aureus. The prognosis of staphylococcal scalded skin syndrome in children is excellent, with complete resolution within 10 days of treatment, and without significant scarring. However, staphylococcal scalded skin syndrome must be differentiated carefully from toxic epidermal necrolysis, which carries a poor prognosis.

Diagnosis and Treatment
Misdiagnosis as eczema lesions such as atopic dermatitis, and application of steroid ointment exacerbates lesions. Please seek medical attention as soon as possible while applying antibiotic ointment.

#First-generation cephalosporins (e.g. Cefradine)
#Bacterial culture
#Third-generation cephalosporins (e.g. Cefditoren Pivoxil)
  • An infant with Staphylococcal scalded skin syndrome
  • It is a characteristic feature of abortive 4S with pustules on the neck.
  • Erythema and scales are present around the mouth and eyes. It can resemble poor hygiene in infants.
References Staphylococcal Scalded Skin Syndrome 28846262 
Staphylococcal Scalded Skin Syndrome is a disease characterized by denudation of the skin caused by exotoxin producing strains of the Staphylococcus species, typically from a distant site. It usually presents 48 hours after birth and is rare in children older than six years. It may also present in immunocompromised adults or those with severe renal disease. The disorder is characterized by significant exfoliation of skin following cellulitis. The severity may vary from a few blisters to system exfoliation leading to marked hypothermia and hemodynamic instability.
 Staphylococcal Scalded Skin Syndrome and Bullous Impetigo 34833375 
Staphylococcal scalded skin syndrome (SSSS) and bullous impetigo are infections caused by Staphylococcus aureus. Bullous impetigo is due to the local release of these toxins and thus, often presents with localized skin findings, whereas SSSS is from the systemic spread of these toxins, resulting in a more generalized rash and severe presentation. Both conditions are treated with antibiotics that target S. aureus. These conditions can sometimes be confused with other conditions that result in superficial blistering.
 Staphylococcal Scalded Skin Syndrome in a Ten-Month-Old Male - Case reports 35989790 
A 10-month-old male presented with rhinorrhea and decreased oral intake and was diagnosed with an upper respiratory infection. Two days later, he returned to the clinic due to a lack of improvement and the onset of new symptoms, including facial edema and perioral skin irritation. That evening, he became febrile at 100.4 °F and went to the emergency department at the local children's hospital. No further workup was done and the parents were instructed to continue with the current treatment regimen. Over the next 48 hours, the patient's symptoms worsened with the new onset of bilateral extremity edema and desquamation. The patient was returned to the emergency department. A physical exam was notable for a blanching, desquamating, erythematous rash on the face and creases of the arms, legs, and groin. A positive Nikolsky sign was reported. A clinical diagnosis of staphylococcal scalded skin syndrome (SSSS) was made, and the patient was started on intravenous clindamycin. This case illustrates a severe presentation of SSSS in a pediatric patient, demonstrating the challenges it poses to diagnosis and treatment.
 Staphylococcal scalded skin syndrome - Case reports 23761500 
A 2-year-old girl presented a generalised rash with 48 h of evolution, in the context of insect bites on the face on the day before. At observation, she had a generalised micropapular rash with confluent areas and Nikolsky sign. There was no mucosal area affected. Blood cultures were negative.