Scalded skin syndrome: MedlinePlus Medical Encyclopedia

P Scalded skin syndrome is a skin infection caused by bacteria in which the skin becomes damaged and sheds.

T Causes
P Scalded skin syndrome (SSS) is caused by infection with certain strains of Staphylococcus bacteria. The bacteria produce a toxin that causes the skin damage. The damage creates blisters, as if the skin were scalded. These blisters can occur;at areas of the skin away from the initial site.
P SSS is found most commonly in infants and children under the age of 5.

T Symptoms
P Symptoms may include any of the following:
- Blisters
- Fever
- Large areas of skin peel or fall away (exfoliation or desquamation)
- Painful skin
- Redness of the skin (erythema), which spreads to cover most of the body
- Skin slips off with gentle pressure, leaving wet red areas (Nikolsky sign)

T Exams and Tests
P The health care provider will perform a physical exam and look at the skin. The exam may show that the skin slips off when it is rubbed (positive Nikolsky sign).
P Tests may include:
- Complete blood count (CBC)
- Cultures of the skin, throat and nose, and blood
- Electrolyte test
- Skin biopsy (in rare cases)

T Treatment
P Antibiotics are given by mouth or through a vein (intravenously; IV) to help fight the infection. IV fluids are also given to prevent dehydration. Much of the body's fluid is lost through open skin.
P Moist compresses to the skin may improve comfort. You can apply a moisturizing ointment to keep the skin moist. Healing begins about 10 days after treatment.

T Outlook (Prognosis)
P A full recovery is expected.

T Possible Complications
P Complications that may result include:
- Abnormal level of fluids in the body causing dehydration or electrolyte imbalance
- Poor temperature control (in young infants)
- Severe bloodstream infection (septicemia)
- Spread to deeper skin infection (cellulitis)

T When to Contact a Medical Professional
P Call your provider or go to the emergency room if you have symptoms of this disorder.

T Prevention
P The disorder may not be preventable. Treating any staphylococcus infection quickly can help.

T Alternative Names
P Ritter disease; Staphylococcal scalded skin syndrome (SSS)

T References
P Koch D, Taibjee SM. Staphylococcal scalded skin syndrome. In: Lebwohl MG, Heymann WR, Berth-Jones J, Coulson I, eds. Treatment of Skin Disease: Comprehensive Therapeutic Strategies. 4th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 223.
P Paller AS, Mancini AJ. Bacterial, mycobacterial, and protozoal infections of the skin. In: Paller AS, Mancini AJ, eds. Hurwitz Clinical Pediatric Dermatology. 5th ed. Philadelphia, PA: Elsevier; 2016:chap 14.

T Review Date 12/10/2015
P Updated by: Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

