Staphylococcal scalded skin syndrome ssss is a serious skin infection. Ssss is caused by the release of two exotoxins epidermolytic toxins a and b from toxigenic strains of the bacteria staphylococcus aureus. Ssss is caused by a type of bacteria called staphylococcus aureus. Clinical and microbiological comparison of staphylococcus. Jan 15, 2006 staphylococcal toxic shock syndrome stss and staphylococcal scalded skin syndrome ssss are 2 distinct toxinmediated diseases with very distinct cutaneous features. Staphylococcal scalded skin syndrome ssss is caused by the exfoliative toxins ets of staphylococcus aureus. The purpose of this article is to familiarize physicians with the evaluation, diagnosis, and treatment of ssss. Staphylococcal scalded skin syndrome ssss is the term used for a collection of blistering skin diseases induced by the exfoliative epidermolytic toxins ets ofstaphylococcus aureus.
In its severe form, the exfoliation can spread to cover the entire body surface area. Staphylococcal scalded skin syndrome ssss refers to a spectrum of blistering skin diseases caused by staphylococcus aureus exfoliative toxins ets 7, 12, 15. The primary infection often begins during the first few days of. Staphylococcal scalded skin syndrome is a pathological condition usually found in children and immune compromised individuals caused due to bacteria staphylococcus aureus. This condition generally affects children staphylococcal scalded skin syndrome ssss is a serious skin infection caused by the bacterium staphylococcus aureus. This boy was born after an uncomplicated pregnancy and delivery. Although exfoliative toxins a and b, which cause ssss, and tss toxin1 may be produced by different strains of s aureus, the two syndromes rarely occur simultaneously. Clinical, microbial, and biochemical aspects of the. Pdf staphylococcal scalded skin syndrome in a neonate. It is rare in adults, but when diagnosed, it often is associated with renal failure, immunodeficiency, or overwhelming staphylococcal infection. The disease is characterized by erythema and exfoliation and is mediated by exotoxins elaborated primarily by phage group ii s aureus. The role of gram staining in staphylococcal scalded skin syndrome.
What is staphylococcal scalded skin syndromecauses. Ssss is caused by the exfoliative toxins epidermolytic toxins a and b of some strains of staphylococcus aureus. Staphylococcal scalded skin syndrome is caused by a staphylococcus or staph infection. It is usually preceded by a mucocutaneous staphylococcal infection, such as pharyngitis or bullous impetigo, though this preceding infection may. In this infection, skin surface of large parts of body gets peeled off and looks like burned skin by hot liquid 1 itani o, crump r, mimouni f, et al. Staphylococcus aureus is the most common form associated with disease.
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. Ritters disease of the newborn is the most severe form of ssss. This bacteria produces a chemical called an epidermolytic toxin epiderm, deriving from the greek words epi, meaning on, and derma, meaning skin, refers to the top layer of skin. Staphylococcal scalded skin syndrome information for parents. Recent developments in staphylococcal scalded skin syndrome. Staphylococcusscalded skin syndrome staff lo cok us skawl did skin sin drome, also known as scalded skin syndrome, ssss, or ritters disease, is a skin infection caused by a bacteria called staphylococcus aureus. Staphylococcal scalded skin syndrome in a 4yearold child. 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. Scalded skin syndrome is a skin reaction to a bacterial infection called staphylococcus aureus. Toxin production is associated with fever, a desquamative skin rash, hypotension, and multiorgan system failure. Staphylococcal scalded skin syndrome evidence search nice.
Staphylococcus scalded skin syndrome staphylococcus scalded skin syndrome is caused by toxins produced when a staph infection gets too severe. Yokota s, imagawa t, katakura s, mitsuda t, arai k. Staphylococcal scalded skin syndrome article about. This bacterium produces an exfoliative toxin that causes the outer layers of. Staphylococcal scalded skin syndrome ssss is a rare disorder with clinical features varying from superficial localized blisters to generalized exfoliation. Contrast with bullous impetigo, where localized infection spreads contiguously. What is staphylococcal scalded skin syndromecausessymptoms. The patient was admitted to our burn centre, and the diagnosis of staphylococcal scalded skin syndrome ssss was.
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. Epidemiological data of staphylococcal scalded skin syndrome in france from 1997 to 2007 and microbiological characteristics of staphylococcus aureus associated strains. 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. Foci of infection include the nasopharynx and, less commonly, the umbilicus, urinary tract, a superficial abrasion, conjunctivae, and blood. Presentation and management of staphylococcal scalded skin. Staphylococcus aureus of phage group ii is the causative organism. Its usually caused by an infection with a type of staphylococcal aureas bacteria. These toxins cause intraepidermal splitting through the granular layer by specific cleavage of desmoglein 1, a desmosomal cadherin protein that mediates cellcell adhesion of keratinocytes in the granular layer. Staphylococcal scalded skin syndrome ssss is the acute, widespread exfoliation of the superficial epidermis at the granular cell layer, 1 mediated by epidermolytic toxins a and b released by staphylococcus aureus bacteria. Staphylococcal scalded skin syndrome is a potentially life. To guide pch ed staff with the assessment and management of staphylococcal scalded skin syndrome in children. Clusters of ssss cases epidemics can occur in newborn nurseries, when staff in. Staphylococcal scalded skin syndrome american academy of. This infection produces a toxin that can affect skin all over the body.
Staphylococcal scalded skin syndrome and toxic shock. Staphylococcal scalded skin syndrome ssss is a potentially lethal complication of a staphylococcus aureus infection. Results for staphylococcal scalded skin syndrome 1 10 of 42 sorted by relevance date click export csv or ris to download the entire page or use the checkboxes to select a subset of records to download. It is a rare condition, which tends to occur in younger children. Early diagnosis and treatment is imperative to reduce the morbidity and mortality of this condition. The staphylococcal scalded skin syndrome may be a consequence of cellulitis, an infection caused by the staphylococcus aureus bacteria as well. May 20, 2014 staphylococcal scalded skin syndrome is a potentially life. Staphylococcal scalded skin syndrome ssss is a skin disorder caused by two exotoxins released from the toxigenic strains of staphylococcus aureus bacteria. Staphylococcal scalded skin syndrome definition staphylococcal scalded skin syndrome ssss is a disease, caused by a type of bacteria, in which large sheets of skin may peel away. Staphylococcal scalded skin syndrome in pregnancy mdedge. Staphylococcal scalded skin syndrome primarily affects children and can cause serious morbidity. It looks like the skin has been scalded or burned by hot liquid. Certain strains of staphylococcus aureus elaborate an exfoliative toxin that is responsible for the cutaneous manifestations of the condition. 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.
The staphylococcal scalded skin syndrome or the ritters disease1 is a staphylococcus aureus skin infection that typically has two periods of incidence. 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. Staphylococcal scalded skin syndrome is caused by group ii coagulasepositive staphylococci, usually phage type 71, which elaborate exfoliatin also called epidermolysin, a toxin that splits the upper part of the epidermis just beneath the granular cell layer by targeting desmoglein1 see also staphylococcal infections. 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 caused by exfoliative toxin bproducing methicillinresistant staphylococcus aureus. The severity of ssss varies from a few blisters in. Staphylococcal scalded skin syndrome is more common in newborns than in adults. A unique case of a pregnant woman with chronic atopic dermatitis who developed ssss is. In this infection, skin surface of large parts of body gets peeled off and looks like burned skin by hot liquid.
Staphylococcal scalded skin syndrome describes a spectrum of superficial blistering skin disorders caused by the exfoliative toxins of staphylococcus aureus. 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. It is usually preceded by a mucocutaneous staphylococcal infection, such as pharyngitis or bullous impetigo, though this preceding infection may go unnoticed by patients. Staphylococcal scalded skin syndrome nord national. Staphylococcal scalded skin syndrome ssss is a toxinmediated systemic illness that is manifested as an epidermal blistering disorder. Staphylococcal scalded skin syndrome tends to appear abruptly with diffuse erythema and fever.
Description ssss primarily strikes children under the age of five, particularly infants. Clinical manifestations of staphylococcal scaldedskin. Staphylococcal scalded skin syndrome knowledge for medical. Staphylococcal scalded skin syndrome knowledge for. Staphylococcalscalded skin syndrome ssss, also known as ritter disease, is a potentially lifethreatening disorder and a pediatric emergency. Caused by a toxin emitted by the bacterium, rather than actual bacterial components, this syndrome leads to broad regions of exfoliating skin and is mainly observed in immunocompromised patients, newborns, infants and young children. Staphylococcal scalded skin syndrome definition of.
Staphylococcal scalded skin syndrome ssss is a superficial blistering disorder mediated by staphylococcus aureus exfoliative toxins. Methicillinresistant staphylococcus aureus mrsa mrsa is one of the most common antibioticresistant strain of staph bacteria. It primarily affects neonates and young children fig. During the course of a few hours, erythema developed on the trunk and blisters in the napkin area. Staphylococcus is a type of bacterium of which there are more than 30 different varieties. Staphylococcal scalded skin syndrome ssss is a superficial blistering disorder mediated by staphylococcus aureus exfoliative toxins ets. Staphylococcal scaled skin syndrome ssss presents generalized form bullous impetigo caused by staphylococcus aureus s. Staphylococcal scalded skin syndrome ssss is a dermatological condition caused by staphylococcus aureus. On the 5th day of life, a small blister was seen on the right buttock and thigh. Staphylococcal scalded skin syndrome bmj case reports. 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.
Staphylococcus scalded skin syndrome ssss ritters disease. Staphylococcal scalded skin syndrome causes, symptoms. Staphylococcal scalded skin syndrome dermatologic disorders. Aug 31, 2016 staphylococcal scalded skin syndrome ssss is counted as one of the major skin infections. We present a case of a 3 days old infant with complaints of fever and diffuse. The desmosomes are a part of skin cell that is responsible for attaching to adjacent skin cell. Neonate with staphylococcal scalded skin syndrome adc fetal. Staphylococcal scalded skin syndrome archives of disease. Summary staphylococcal scalded skin syndrome ssss is a recognised clinical entity that affects primarily the very young and, in rare cases, the very old or the immunocompromised. Staphylococcal scalded skin syndrome primarily affects children and can cause serious. Staphylococcal scalded skin syndrome johns hopkins medicine. It is characterized by a fever, rash, and blisters.
Aug 29, 2014 lamand v, dauwalder o, tristan a, et al. Staphylococcal scalded skin syndrome microbiology society. Differential diagnosis includes toxic epidermal necrolysis, staphylococcal scalded skin syndrome, epidermolysis bullosa, and stevensjohnson syndrome. The infection causes peeling skin over large parts of the body. Staphylococcal scalded skin syndrome ssss, also known as ritter disease, is a potentially lifethreatening disorder and a pediatric emergency. Staphylococcus aureus may cause cutaneous and systemic infections such as staphylococcal scalded skin syndrome ssss and toxic shock syndrome tss.
Typically affects age download the entire page or use the checkboxes to select a subset of records to download. It is important to make a diagnosis early, particularly to differentiate it from ten, which has a different management and much greater. Staphylococcal scalded skin syndrome is an exfoliating skin disease which primarily affects children. 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. Staphylococcal scalded skin syndrome has been described in all age groups, but it is usually seen in children under 5 years of age, including neonates. The infection is more common in children under the age of 5 and for this reason, specialists suspect that the ssss may be due to the fact that the kidneys are not developed properly and cannot filter. Staphylococcal scalded skin syndrome linkedin slideshare.
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 ssss is a toxinmediated epidermolytic disease that occurs mainly in infants and children. Staphylococcus commonly causes skin infections such as boils or impetigo. Staphylococcal scalded skin syndrome ssss is counted as one of the major skin infections. It is a disease primarily affecting infants and young children,2 but cases. Table differential dx of desquamating lesions in neonates 2,3,7 condition characteristics congenital cutaneous generalized eruption of erythematous macules, candidiasis papules, andor pustules with widespread desquamating andor erosive dermatitis congenital syphilis red or pink maculopapular rash more commonly on the soles, followed by desquamation neonatal hsv clustering vesicles on. The toxins adhere themselves to a molecule within desmosome known as desmoglein 1 and. Bacterial skin infection is a relatively frequent condition in paediatric population. 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. Staphylococcal scalded skin syndrome archives of disease in.