Infectious Disease: Scaleded Skin Syndrome

Question 1

Defintion

Answer 1

Staphylococcus scalded skin syndrome (SSSS) = condition caused by a type of staphylococcus aureus bacteria that produces epidermolytic toxins = protease enzymes = break down proteins that hold skin together.
When skin infection occurs these toxins are produced = skin damaged and breaks down.

Question 2

Epidemiology

Answer 2

Children under 5
Older children + adults usually develop immunity to the epidermolytic toxins

Question 3

Signs and symptoms

Answer 3

Generalised patches of erythema on the skin
Skin looks thin and wrinkled
Followed by formation of fluid filled blisters called Bullae = burst and leave very sore, erythematous skin below
Similar appearance to burn or scald.
Nikolsky sign

Systemic symptoms:
- fever
- irritability
- lethargy
- dehydration
- if untreated can lead to sepsis and potentially death

Question 4

Diagnosis

Answer 4

Clinical
Skin biopsy to differentiate from TEN

Question 5

Treatment

Answer 5

Hospitalisation
IV Abx - Flucloxacillin, Cefazolin
Supportive treatment
- IV fluids
- ensuring adequate intake of calories and nutrients

Question 6

Complications

Answer 6

Sepsis
Scarring
Dehydration
Electrolyte abnormalities

Question 7

Risk factors

Answer 7

Infants
Skin conditions
Recent surgery
Close contact with individuals