Dermatologic Manifestations of Staphylococcal Scalded Skin Syndrome Workup

  • Author: Jessica H Kim, MD; Chief Editor: Dirk M Elston, MD   more...
 
Updated: Jan 12, 2012
 

Laboratory Studies

  • The definitive diagnosis of staphylococcal scalded skin syndrome (SSSS) depends on culture and biopsy results.
  • Examination of frozen sections of the lesions can easily confirm the diagnosis.
  • Slide latex agglutination, double immunodiffusion, and enzyme-linked immunosorbent assay tests can identify the toxins responsible for staphylococcal scalded skin syndrome.
  • Perform culturing in all patients with suspected staphylococcal scalded skin syndrome for identification and antibiotic sensitivities of the causative organism. S aureus may be cultured from the conjunctiva, nasopharynx, feces, or pyogenic foci on the skin. Blood cultures are almost always negative in children, but they may be positive in adults.
  • Investigate the possibility of a staphylococcal carrier in the vicinity.
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Histologic Findings

All forms of scalded skin syndrome are characterized by intraepidermal cleavage, with splitting that occurs beneath and within the stratum granulosum. The cleavage space may contain free-floating or partially attached acantholytic cells. The remainder of the epidermis appears unremarkable, and the dermis contains no inflammatory cells.

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Contributor Information and Disclosures
Author

Jessica H Kim, MD  Clinical Assistant Professor, Division of Dermatology, University of Washington School of Medicine; Dermatology Consultant, Cascade Eye & Skin Centers

Jessica H Kim, MD is a member of the following medical societies: American Academy of Dermatology, American Contact Dermatitis Society, American Society for Dermatologic Surgery, American Society for Laser Medicine and Surgery, National Psoriasis Foundation, Washington State Medical Association, and Women's Dermatologic Society

Disclosure: Nothing to disclose.

Coauthor(s)

Paul Benson, MD  Chief, Program Director, Dermatology Service, Walter Reed Army Medical Center; Associate Professor, Department of Dermatology, Uniformed Services University of the Health Sciences at Bethesda

Paul Benson, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Specialty Editor Board

Leonard Sperling, MD  Chair, Professor, Department of Dermatology, Uniformed Services University of the Health Sciences

Leonard Sperling, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Michael J Wells, MD  Associate Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine

Michael J Wells, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, and Texas Medical Association

Disclosure: Nothing to disclose.

Edward F Chan, MD  Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania School of Medicine

Edward F Chan, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, and Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Catherine M Quirk, MD  Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania

Catherine M Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD  Director, Ackerman Academy of Dermatopathology, New York

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

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An infant with characteristic coloring in the skin that looks as though the child has been scalded.
Staphylococcal scalded skin syndrome in an adult.
 
 
 
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