Staphylococcal Scalded Skin Syndrome (SSSS) Questions & Answers

1. Brazel M, Desai A, Are A, Motaparthi K. Staphylococcal Scalded Skin Syndrome and Bullous Impetigo. Medicina (Kaunas). 2021 Oct 24. 57 (11):[QxMD MEDLINE Link]. [Full Text].

2. Hubiche T, Bes M, Roudiere L, Langlaude F, Etienne J, Del Giudice P. Mild staphylococcal scalded skin syndrome: an underdiagnosed clinical disorder. Br J Dermatol. 2012 Jan. 166(1):213-5. [QxMD MEDLINE Link].

3. Adhisivam B, Mahadevan S. Abscess of the nasal septum with staphylococcal scalded skin syndrome. Indian Pediatr. 2006 Apr. 43(4):372-3. [QxMD MEDLINE Link].

4. Amagai M, Yamaguchi T, Hanakawa Y, Nishifuji K, Sugai M, Stanley JR. Staphylococcal exfoliative toxin B specifically cleaves desmoglein 1. J Invest Dermatol. 2002 May. 118(5):845-50. [QxMD MEDLINE Link].

5. Hanakawa Y, Stanley JR. Mechanisms of blister formation by staphylococcal toxins. J Biochem. 2004 Dec. 136(6):747-50. [QxMD MEDLINE Link].

6. Ladhani S. Understanding the mechanism of action of the exfoliative toxins of Staphylococcus aureus. FEMS Immunol Med Microbiol. 2003 Nov 28. 39(2):181-9. [QxMD MEDLINE Link].

7. Patel GK, Finlay AY. Staphylococcal scalded skin syndrome: diagnosis and management. Am J Clin Dermatol. 2003. 4(3):165-75. [QxMD MEDLINE Link].

8. Rydzewska-Rosolowska A, Brzosko S, Borawski J, Mysliwiec M. Staphylococcal scalded skin syndrome in the course of lupus nephritis. Nephrology (Carlton). 2008 Jun. 13(3):265-6. [QxMD MEDLINE Link].

9. Staiman A, Hsu DY, Silverberg JI. Epidemiology of staphylococcal scalded skin syndrome in U.S. children. Br J Dermatol. 2018 Mar. 178 (3):704-708. [QxMD MEDLINE Link].

10. Murono K, Fujita K, Yoshioka H. Microbiologic characteristics of exfoliative toxin-producing Staphylococcus aureus. Pediatr Infect Dis J. 1988 May. 7(5):313-5. [QxMD MEDLINE Link].

11. Hayward A, Knott F, Petersen I, Livermore DM, Duckworth G, Islam A. Increasing hospitalizations and general practice prescriptions for community-onset staphylococcal disease, England. Emerg Infect Dis. 2008 May. 14(5):720-6. [QxMD MEDLINE Link]. [Full Text].

12. Decleire PY, Blondiaux G, Delaere B, Glupczynski Y. Staphyloccocal scalded skin syndrome in an adult. Acta Clin Belg. 2004 Nov-Dec. 59(6):365-8. [QxMD MEDLINE Link].

13. Oono T, Kanzaki H, Yoshioka T, Arata J. Staphylococcal scalded skin syndrome in an adult. Identification of exfoliative toxin A and B genes by polymerase chain reaction. Dermatology. 1997. 195(3):268-70. [QxMD MEDLINE Link].

14. Shirin S, Gottlieb AB, Stahl EB. Staphylococcal scalded skin syndrome in an immunocompetent adult: possible implication of low-dosage prednisone. Cutis. 1998 Nov. 62(5):223-4. [QxMD MEDLINE Link].

15. Wong GW, Oppenheimer SJ, Evans RM, Leung SS, Cheng JC. Pyomyositis and staphylococcal scalded skin syndrome. Acta Paediatr. 1993 Jan. 82(1):113-5. [QxMD MEDLINE Link].

16. Norbury WB, Gallagher JJ, Herndon DN, Branski LK, Oehring PE, Jeschke MG. Neonate twin with staphylococcal scalded skin syndrome from a renal source. Pediatr Crit Care Med. 2010 Mar. 11(2):e20-3. [QxMD MEDLINE Link].

17. Kadam S, Tagare A, Deodhar J, Tawade Y, Pandit A. Staphylococcal scalded skin syndrome in a neonate. Indian J Pediatr. 2009 Oct. 76(10):1074. [QxMD MEDLINE Link].

18. Kapoor V, Travadi J, Braye S. Staphylococcal scalded skin syndrome in an extremely premature neonate: a case report with a brief review of literature. J Paediatr Child Health. 2008 Jun. 44(6):374-6. [QxMD MEDLINE Link].

19. O'Connell NH, Mannix M, Philip RK, MacDonagh-White C, Slevin B, Monahan R, et al. Infant Staphylococcal scalded skin syndrome, Ireland, 2007--preliminary outbreak report. Euro Surveill. 2007 Jun 14. 12(6):E070614.5. [QxMD MEDLINE Link].

20. Duijsters CE, Halbertsma FJ, Kornelisse RF, Arents NL, Andriessen P. Recurring staphylococcal scalded skin syndrome in a very low birth weight infant: a case report. J Med Case Reports. 2009. 3:7313. [QxMD MEDLINE Link]. [Full Text].

21. El Helali N, Carbonne A, Naas T, Kerneis S, Fresco O, Giovangrandi Y, et al. Nosocomial outbreak of staphylococcal scalded skin syndrome in neonates: epidemiological investigation and control. J Hosp Infect. 2005 Oct. 61(2):130-8. [QxMD MEDLINE Link].

22. Brewer JD, Hundley MD, Meves A, Hargreaves J, McEvoy MT, Pittelkow MR. Staphylococcal scalded skin syndrome and toxic shock syndrome after tooth extraction. J Am Acad Dermatol. 2008 Aug. 59(2):342-6. [QxMD MEDLINE Link].

23. Moss C, Gupta E. The Nikolsky sign in staphylococcal scalded skin syndrome. Arch Dis Child. 1998 Sep. 79(3):290. [QxMD MEDLINE Link].

24. Uzun S, Durdu M. The specificity and sensitivity of Nikolskiy sign in the diagnosis of pemphigus. J Am Acad Dermatol. 2006 Mar. 54(3):411-5. [QxMD MEDLINE Link].

25. Acland KM, Darvay A, Griffin C, Aali SA, Russell-Jones R. Staphylococcal scalded skin syndrome in an adult associated with methicillin-resistant Staphylococcus aureus. Br J Dermatol. 1999 Mar. 140(3):518-20. [QxMD MEDLINE Link].

26. Ito Y, Funabashi Yoh M, Toda K, Shimazaki M, Nakamura T, Morita E. Staphylococcal scalded-skin syndrome in an adult due to methicillin-resistant Staphylococcus aureus. J Infect Chemother. 2002 Sep. 8(3):256-61. [QxMD MEDLINE Link].

27. Noguchi N, Nakaminami H, Nishijima S, Kurokawa I, So H, Sasatsu M. Antimicrobial agent of susceptibilities and antiseptic resistance gene distribution among methicillin-resistant Staphylococcus aureus isolates from patients with impetigo and staphylococcal scalded skin syndrome. J Clin Microbiol. 2006 Jun. 44(6):2119-25. [QxMD MEDLINE Link].

28. Kaplan SL, Deville JG, Yogev R, Morfin MR, Wu E, Adler S, et al. Linezolid versus vancomycin for treatment of resistant Gram-positive infections in children. Pediatr Infect Dis J. 2003 Aug. 22 (8):677-86. [QxMD MEDLINE Link].

29. Kimberlin DW, Brady MT, Jackson MA, Long SS. Staphylococcal infections. American Academy of Pediatrics Red Book. 30th. 2015. 22: 715.

30. Al-Dhalimi MA. Neonatal and infantile erythroderma: a clinical and follow-up study of 42 cases. J Dermatol. 2007 May. 34(5):302-7. [QxMD MEDLINE Link].

31. Baartmans MG, Maas MH, Dokter J. Neonate with staphylococcal scalded skin syndrome. Arch Dis Child Fetal Neonatal Ed. 2006 Jan. 91(1):F25. [QxMD MEDLINE Link]. [Full Text].

32. Chi CY, Wang SM, Lin HC, Liu CC. A clinical and microbiological comparison of Staphylococcus aureus toxic shock and scalded skin syndromes in children. Clin Infect Dis. 2006 Jan 15. 42(2):181-5. [QxMD MEDLINE Link].

33. Cribier B, Piemont Y, Grosshans E. Staphylococcal scalded skin syndrome in adults. A clinical review illustrated with a new case. J Am Acad Dermatol. 1994 Feb. 30(2 Pt 2):319-24. [QxMD MEDLINE Link].

34. El Helali N, Carbonne A, Naas T, et al. Nosocomial outbreak of staphylococcal scalded skin syndrome in neonates: epidemiological investigation and control. J Hosp Infect. 2005 Oct. 61(2):130-8. [QxMD MEDLINE Link].

35. Ginsburg CM. Staphylococcal toxin syndromes. Pediatr Infect Dis J. 1991 Apr. 10(4):319-21. [QxMD MEDLINE Link].

36. Greenwood JE, Dunn KW, Davenport PJ. Experience with severe extensive blistering skin disease in a paediatric burns unit. Burns. 2000 Feb. 26(1):82-7. [QxMD MEDLINE Link].

37. Hedrick J. Acute bacterial skin infections in pediatric medicine: current issues in presentation and treatment. Paediatr Drugs. 2003. 5 Suppl 1:35-46. [QxMD MEDLINE Link].

38. Hochman MA, Mayers M. Stevens-Johnson syndrome, epidermolysis bullosa, staphylococcal scalded skin syndrome, and dermatitis herpetiformis. Int Ophthalmol Clin. 1997 Spring. 37(2):77-92. [QxMD MEDLINE Link].

39. Johnston GA. Treatment of bullous impetigo and the staphylococcal scalded skin syndrome in infants. Expert Rev Anti Infect Ther. 2004 Jun. 2(3):439-46. [QxMD MEDLINE Link].

40. Ladhani S, Evans RW. Staphylococcal scalded skin syndrome. Arch Dis Child. 1998 Jan. 78(1):85-8. [QxMD MEDLINE Link].

41. Ladhani S, Joannou CL, Lochrie DP, Evans RW, Poston SM. Clinical, microbial, and biochemical aspects of the exfoliative toxins causing staphylococcal scalded-skin syndrome. Clin Microbiol Rev. 1999 Apr. 12(2):224-42. [QxMD MEDLINE Link].

42. Lina G, Gillet Y, Vandenesch F, Jones ME, Floret D, Etienne J. Toxin involvement in staphylococcal scalded skin syndrome. Clin Infect Dis. 1997 Dec. 25(6):1369-73. [QxMD MEDLINE Link].

43. Payne AS, Hanakawa Y, Amagai M, Stanley JR. Desmosomes and disease: pemphigus and bullous impetigo. Curr Opin Cell Biol. 2004 Oct. 16(5):536-43. [QxMD MEDLINE Link].

44. Prevost G, Couppie P, Monteil H. Staphylococcal epidermolysins. Curr Opin Infect Dis. 2003 Apr. 16(2):71-6. [QxMD MEDLINE Link].

45. Resnick SD. Staphylococcal toxin-mediated syndromes in childhood. Semin Dermatol. 1992 Mar. 11(1):11-8. [QxMD MEDLINE Link].

46. Rodriguez Prieto MA, Manchado Lopez P, Ruiz Gonzalez I. Toxic epidermal necrolysis associated with scalded skin syndrome in an adult. Int J Dermatol. 1997 Nov. 36(11):875-6. [QxMD MEDLINE Link].

47. Shelley ED, Shelley WB, Talanin NY. Chronic staphylococcal scalded skin syndrome. Br J Dermatol. 1998 Aug. 139(2):319-24. [QxMD MEDLINE Link].

48. Veien NK. The clinician's choice of antibiotics in the treatment of bacterial skin infection. Br J Dermatol. 1998 Dec. 139 Suppl 53:30-6. [QxMD MEDLINE Link].

49. Whittock NV, Bower C. Targetting of desmoglein 1 in inherited and acquired skin diseases. Clin Exp Dermatol. 2003 Jul. 28(4):410-5. [QxMD MEDLINE Link].

50. Williams RE, MacKie RM. The staphylococci. Importance of their control in the management of skin disease. Dermatol Clin. 1993 Jan. 11(1):201-6. [QxMD MEDLINE Link].

51. Wooldridge WE. Managing skin infections in children. Postgrad Med. 1991 Mar. 89(4):109-12. [QxMD MEDLINE Link].

52. Yamasaki O, Yamaguchi T, Sugai M, et al. Clinical manifestations of staphylococcal scalded-skin syndrome depend on serotypes of exfoliative toxins. J Clin Microbiol. 2005 Apr. 43(4):1890-3. [QxMD MEDLINE Link].

Randall W King, MD, FACEP Assistant Clinical Professor of Emergency Medicine, University of Toledo College of Medicine; Director, Emergency Medicine Residency Program, Department of Emergency Medicine, Chief Medical Information Officer, Chief of Staff Elect, Mercy St Vincent Medical Center

Randall W King, MD, FACEP is a member of the following medical societies: American College of Emergency Physicians, Council of Residency Directors in Emergency Medicine, American Medical Association, Ohio State Medical Association, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Heather Lyn Carone, MD Attending Physician, Department of Emergency Medicine, St Vincent Mercy Medical Center

Heather Lyn Carone, MD is a member of the following medical societies: American College of Emergency Physicians, American Medical Association, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Paul R de Saint Victor, MD, FACEP Chief of Staff, St Vincent Mercy Medical Center, Toledo

Paul R de Saint Victor, MD, FACEP is a member of the following medical societies: American College of Emergency Physicians, American Heart Association, National Association of EMS Physicians, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Jeter (Jay) Pritchard Taylor, III, MD Assistant Professor, Department of Surgery, University of South Carolina School of Medicine; Attending Physician / Clinical Instructor, Compliance Officer, Department of Emergency Medicine, Prisma Health Richland Hospital

Jeter (Jay) Pritchard Taylor, III, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, Columbia Medical Society, Society for Academic Emergency Medicine, South Carolina College of Emergency Physicians, South Carolina Medical Association

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Employed contractor - Chief Editor for Medscape.

Daniel J Dire, MD, FACEP, FAAP, FAAEM Professor of Pediatrics and Emergency Medicine, University of Texas Health Science Center at San Antonio, Joe R and Teresa Lozano Long School of Medicine

Daniel J Dire, MD, FACEP, FAAP, FAAEM is a member of the following medical societies: American Academy of Clinical Toxicology, American Academy of Emergency Medicine, American Academy of Pediatrics, American College of Emergency Physicians, Association of Military Surgeons of the US

Disclosure: Nothing to disclose.

The authors and editors of Medscape Reference gratefully acknowledge the medical review of this article by Joseph U Becker, MD.

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