Staphylococcal scalded skin syndrome (SSSS) is a condition that usually affects children and infants who have not yet developed antibodies to Staphylococcus aureus (Staph. aureus). The syndrome rarely occurs in adults unless they have kidney failure or depressed immune systems.
SSSS occurs when a child is exposed to an adult who is carrying Staph. aureus either on their skin or in their nasal passages. The bacteria is passed to the child and an infection develops. Exotoxins are released that disrupt the outer skin’s ability to adhere to the under layers.
About 15-40 percent of healthy humans are carriers of Staph. aureus though they do not have symptoms of the infection themselves, according to Dermnetnz.com.
Symptoms start from an isolated infected lesion that may look like impetigo, the Merck manual reported. In newborns the diaper area may be affected. In older children the face may be involved.
The child develops red sensitive skin that erupts into fluid-filled blisters within 24 to 48 hours. The syndrome continues progresses to look like a burn and the skin peels off, often in large sheets to the slightest touch or gentle pushing describes the Merck Manual.
A day or two after the rash appears the child can become more ill with symptoms of fever, chills and weakness.
Diagnosis can be difficult. Scalded skin syndrome is diagnosed with a biopsy and a bacterial culture according to discoveryhealth.com. A biopsy is when a small area of skin is sent to the lab to be viewed under the microscope. Swabs from the nose and throat will be cultured for bacteria.
Dehydration and susceptibility to additional infections are serious concerns for children with scalded skin syndrome. Intravenous antibiotics and fluid replacement will be given to the child.
Intravenous antibiotics may be administered for one week, then oral antibiotics may follow. The child should also be encouraged to drink extra fluids to replace loss from their skin.
Topical skin care using creams and special non-adherent dressing changes will be performed, due to the skin being so fragile.
Pain meds are also given to ease discomfort.
Good hand washing by everyone in contact with the child is very important to avoid spreading the infection.
Typically scalded skin syndrome follows a benign course without scarring after a week of treatment. However if left untreated, it can lead to more severe infections and possibly death.
Scalded Skin Syndrome by Elizabeth Whitmore. Discovery fit & health. Retrieved Sept 7, 2012.
Carolyn Simpson, RGN, RSCN. The management of staphylococcal scalded skin syndrome in infants. 21 October, 2003. VOL: 99, ISSUE: 42, PAGE NO: 59
Retrieved Sept 7, 2012.
Staphylococcal scalded skin syndrome. DermNet NZ. Retrieved Sept 7, 2012.
Staphylococcal Scalded Skin Syndrome. The Merck Manual Home Health Handbook. Retrieved Sept 7, 2012.
Michele is an R.N. freelance writer with a special interest in woman’s healthcare and quality of care issues. Other articles by Michele are at www.helium.com/users/487540/show_articles
Edited by Jody Smith