What is Staphylococcal Scalded Skin Syndrome?

Staphylococcal Scalded Skin Syndrome is a pathological condition usually found in children and immune compromised individuals caused due to bacteria Staphylococcus aureus. 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 is basically caused by toxins released from the bacteria. These toxins attach themselves on the molecules of desmosomes. The desmosomes are responsible for two cells being united and being stuck to each other. Because of the toxins attaching to the molecules of the desmosomes causes it to break resulting in the cells of the body to start becoming unstuck causing the blisters or burns on the skin surface.

Staphylococcal Scalded Skin Syndrome is also known by the name of Ritter disease or Lyell disease, especially when this condition develops in newborns and young infants. As stated, Staphylococcal Scalded Skin Syndrome is mostly seen in children, especially newborns.

Older children and adults are less likely to get Staphylococcal Scalded Skin Syndrome as the child grows he or she starts to develop antibodies against the toxins causing Staphylococcal Scalded Skin Syndrome, although adults with a compromised immune system may get predisposed to get Staphylococcal Scalded Skin Syndrome.

Also, individuals with a renal dysfunction such that toxins in the body are not able to be completely cleared by the renal system may also develop Staphylococcal Scalded Skin Syndrome.

What are the Causes of Staphylococcal Scalded Skin Syndrome?

Staphylococcal Scalded Skin Syndrome basically begins with a staphylococcal infection which produces exotoxins namely epidermolytic toxins A and B which tend to break the connectivity between two cells by attaching themselves to the molecules of desmosomes breaking the connectivity of the cells and causing Staphylococcal Scalded Skin Syndrome.

The initial bacterial infection may start at a daycare facility where a lot of people who may be asymptomatic but may be carrier of the bacteria may spread the infection to a child which may ultimately result in Staphylococcal Scalded Skin Syndrome.

It is estimated that about 40% of healthy individuals are carriers of this bacterium and are completely asymptomatic but have the potency to spread the bacteria to others who may not have the same immune system and tend to develop an infection which may go on to Staphylococcal Scalded Skin Syndrome. Since skin infections are more common in children thus they have an increased propensity to develop Staphylococcal Scalded Skin Syndrome.

What are the Symptoms of Staphylococcal Scalded Skin Syndrome?

The presenting symptoms of Staphylococcal Scalded Skin Syndrome are fever, irritability and diffuse redness of the skin. With a couple of days of the exposure to the infection there is will be formation of skin blisters that are classic symptoms of Staphylococcal Scalded Skin Syndrome.

These skin blisters tend to rupture quite easily and leave behind what looks like a burn mark. The characteristics of the rashes formed can be described as wrinkling of the skin to begin with and then followed by fluid filled blisters usually in the armpits, and other parts of the body including the ears and the nose.

This rash progressively spreads to other parts of the body to include trunk, upper and lower extremities, and around the diaper area. This is then followed by peeling of the top layer of the skin leaving behind a tender moist area which may look like a burn.

How is Staphylococcal Scalded Skin Syndrome Diagnosed?

The diagnosis of Staphylococcal Scalded Skin Syndrome can be made by taking a detailed history and conducting a thorough physical examination of the affected areas to look for tender spot. A blood test will easily identify the bacteria at play here and confirm the diagnosis of Staphylococcal Scalded Skin Syndrome.

How is Staphylococcal Scalded Skin Syndrome Treated?

Since Staphylococcal Scalded Skin Syndrome is mostly found in newborns and their immune system is not fully developed yet thus treatment for this condition is done in an inpatient setting with intravenous antibiotics until the child is completely infection free. The medication of choice used to treat Staphylococcal Scalded Skin Syndrome is flucloxacillin, although other antibiotics like nafcillin, cephalosporin, and clindamycin may also be used.

If the infection is supposed to be caused by MRSA then Vancomycin has been shown to be quite beneficial in treating Staphylococcal Scalded Skin Syndrome. Once the child starts to respond to treatment the intravenous line may be taken off and oral antibiotics are started which may continue for a few days. The course of oral antibiotics may need be given in a hospital setting and can also be given at home after the child is discharged.

Some of the other treatment options for treatment of Staphylococcal Scalded Skin Syndrome are paracetamol for control of fever, maintaining adequate fluid intake throughout the course of the infection to prevent dehydration, skin moisturizers to keep the skin wet and well taken care of.

In some cases newborn babies may be kept in incubators for a few days if they are diagnosed with Staphylococcal Scalded Skin Syndrome. The recovery period of this condition is usually a week and within 10 days the child may be completely free of Staphylococcal Scalded Skin Syndrome.

Prevention of Staphylococcal Scalded Skin Syndrome

If a child goes to a daycare center or a childcare facility and there is an outbreak of Staphylococcal Scalded Skin Syndrome, then it is extremely important to identify the source of the infection which may be a caregiver, parent, or a visitor.

It may be difficult to single out one person who may be a carrier of the bacteria but in case if one is identified then the individual may be given antibiotics to eradicate the infection. Additionally, it should be made mandatory for childcare institutions to instruct the workers to use hand sanitizer and wash hands thoroughly before even getting close to the baby in order to prevent an outbreak of Staphylococcal Scalded Skin Syndrome.

Written, Edited or Reviewed By:

, MD, FFARCSI

Last Modified On: July 27, 2017

Pain Assist Inc.

Pramod Kerkar
  Note: Information provided is not a substitute for physician, hospital or any form of medical care. Examination and Investigation is necessary for correct diagnosis.

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