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What is staphylococcal scalded skin syndrome?

Staphylococcal scalded skin syndrome (SSSS) is a serious skin infection. The infection causes peeling skin over large parts of the body. It looks like the skin has been scalded or burned by hot liquid. It’s more common in the summer and fall.


What causes SSSS?

It’s usually caused by an infection with a type of Staphylococcal aureus bacteria. The bacteria release poison (toxins) that cause the skin to blister and peel.


Who is at risk for SSSS?

It can occur at any age, but children under 5 years of age are at highest risk. Other risk factors include:

  • Weak immune system
  • Long-term (chronic) kidney disease or kidney failure


What are the symptoms of SSSS?

Symptoms can occur a bit differently in each patient. They can include:

  • Fussiness (irritability)
  • Tiredness
  • Fever
  • Redness of the skin
  • Fluid-filled blisters that break easily and leave an area of moist skin that soon becomes tender and painful
  • Large sheets of the top layer of skin may peel away

The symptoms of staphylococcal scalded skin syndrome can be like other health conditions. Make sure you or your child sees a healthcare provider for a diagnosis.


How is SSSS diagnosed?

Your physician will ask about you or your child’s symptoms and medical history. A physical exam will be given and tests, such as:

  • Skin biopsy. A tiny sample of skin is taken and checked under a microscope. A frozen section can be done quickly to confirm the diagnosis.
  • Cultures. These are simple tests to check for bacteria. Cultures may be done of the blood, urine, nose and throat, and skin. In newborns, a culture of the belly button may also be done.


How is SSSS treated?

Your physician will figure out the best treatment plan for you or your child based on:

  • Your child’s age, overall health, and medical history
  • How severe your child’s condition is
  • How well your child handles certain medicines, treatments, or therapies
  • If your child’s condition is expected to get worse
  • The opinion of the healthcare providers involved in your child's care
  • Your opinion and preference

You or your child will likely need to be treated in the hospital and may be in the burn unit; this is because the treatment is similar to treating a patient with burns. Or you or your child may be treated in the intensive care unit (ICU). Treatment may include:

  • Antibiotic medicine is given by IV (intravenous) line into the vein
  • IV fluids to prevent dehydration
  • Feedings through a tube from the mouth into the stomach (nasogastric feeding), if needed
  • Use of skin creams or ointments and bandages
  • Pain medicines