Staphylococcal Scalded Skin syndrome (SSSS)

SSSS is caused by hematogenous dissemination of exfoliative toxin produced by S.aureus, a toxin-producing staphylococcus

-Bullous impetigo is caused by the same exfoliative toxins when they affect the skin locally. 

-SSSS is most common in neonates and children under the age of 5 years

Symptoms & Signs: Tender, macular erythema develop abruptly over the face, axilla, and groin; as they spread, they form blisters over all parts of the body;  the blisters enlarge to slough and give ‘rolled up’ sandpaper-like texture to skin 

-Lateral traction of the skin reveals the splitting of the epidermis from the dermis (Nikolsky sign)

Diagnosis: can be established by skin biopsy and isolation of Staph aureus from the lesions 

Treatment: Antistaphylococcal antibiotics, intravenous fluids and supportive measures 

Healing occurs in 7 to 10 days.