Drexel University College of Medicine

Diseases and Conditions

Scalded skin syndrome

Definition

Scalded skin syndrome is a skin infection in which the skin becomes damaged and sheds.

Alternative Names

Ritter disease; Staphylococcal scalded skin syndrome (SSS)

Causes, incidence, and risk factors

Scalded skin syndrome is caused by infection with certain strains of bacteria in the Staphylococcus family. During the infection, the staphylococci produce a poison that causes the skin damage. The damage creates blisters as if the skin were scalded.

Scalded skin syndrome is found most commonly in infants and children under the age of 5.

Symptoms

• 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's sign)

Signs and tests

• Positive Nikolsky's sign (skin slipping off when rubbed)

Tests include:

• Complete blood count (CBC)
• Cultures of the skin and throat
• Electrolyte test
• Skin biopsy (done only in rare cases, such as when the skin condition may be due to a drug reaction known as toxic epidermal necrolysis or TEN)

Treatment

Intravenous antibiotics for staphylococcus are given to help fight the infection. Because much fluid is lost through the open skin, it's important to get intravenous fluid to prevent dehydration.

Moist compresses to the skin may improve comfort. You can apply an emollient to keep the skin moist. Healing begins about 10 days after treatment.

Expectations (prognosis)

The prognosis is usually excellent. A full recovery is expected.

Complications

• Fluid regulation problems causing dehydration or electrolyte imbalance
• Poor temperature control (in young infants)
• Severe bloodstream infection (septicemia)
• Spread to deeper skin infection (cellulitis)

Calling your health care provider

Call your health care provider or go to the emergency room if you have symptoms of this disorder.

Prevention

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

References

Korman NJ. Macular, papular, vesiculobullous, and pustular diseases. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 465.

Physician Reference

International Classification of Diseases, 9^th Revision (ICD9)

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only - they do not constitute endorsements of those other sites. Copyright 2009 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.