Staphylococcal Scalded Skin Syndrome (SSSS) - Symptoms, causes and treatment

Staphylococcal scalded skin syndrome (SSSS) is a skin disease caused by a bacterial infection Staphylococcus aureus. SSSS is characterized by redness, blistering, and a burning sensation.

SSSS occurs due to toxins released by bacteria Staphylococcus aureus. This poison can cause damage to the skin and trigger the appearance of blisters that cause pain like burning.

SSSS can happen to anyone, including children and newborns. SSSS that affects newborns and children is also known as Ritter's disease or Lyell's disease.

Symptoms of Staphylococcal Scalded Skin Syndrome (SSSS)

SSSS begins with the appearance of a red rash on the skin with the following characteristics:

  • Initially the rash looks like wrinkles on the skin, then 1-2 days later, fluid-filled blisters appear in the armpits, groin, nose, and ears area.
  • The fluid-filled blisters break easily and leave a burn-like scar on the skin.
  • The rash spreads to other areas, such as the arms and legs. In newborns, blisters can appear in the navel area, around the genitals, and buttocks.
  • The top layer of skin peels off, so the skin looks red and painful to the touch.

After the skin peels off, people with SSSS may experience other symptoms, such as:

  • Fever
  • Shivering
  • Symptoms of dehydration
  • Decreased appetite
  • Body tired easily
  • Fussiness (in children)

When to go to the doctor

Go to the doctor immediately or take your child to the doctor if a rash appears on the skin with the characteristics as described above. Treatment done when the rash is still mild will reduce the risk of the disease getting worse and prevent complications.

SSSS can affect adults who have weak immune systems and kidney disease. Therefore, check your condition regularly to the doctor if you experience both conditions.

Causes of Staphylococcal Scalded Skin Syndrome (SSSS)

SSSS is caused by a bacterial infection Staphylococcus aureus. These bacteria normally live on the skin of adults without causing disease. New problems will arise when bacteria enter the body through open wounds, then release toxins that damage the skin.

SSSS tends to occur in newborns and children under 5 years of age. This is because their immune system and kidney function are not fully developed. Adults with weak immunity and impaired kidney function are also susceptible to this condition.

A person can get SSSS if they share a towel with an infected person. SSSS transmission can also occur if accidentally exposed to splashes of saliva when an infected person coughs or sneezes.

Diagnosis of Staphylococcal Scalded Skin Syndrome (SSSS)

In order to determine the disease of SSSS, the doctor will ask about the symptoms experienced and the patient's medical history. Then the doctor will perform a physical examination by looking at the characteristics of the rash.

To make sure the skin disorder is caused by SSSS or not, the doctor will carry out the following investigations:

  • Complete blood count.
  • Examination of bacterial cultures through samples of skin, blood, urine, or the umbilical cord of a newborn.
  • Tissue sampling (biopsy) of infected skin.

Treatment of Staphylococcal Scalded Skin Syndrome (SSSS)

Treatment of SSSS depends on the patient's age, severity, and overall health condition. The doctor will also take into account whether the patient's condition will improve or worsen if treatment is carried out.

Most patients with SSSS are treated in hospital burn units because the treatment method is the same as for burn patients. Treatment carried out in the hospital includes:

  • Administration of pain medication.
  • Oral or injectable antibiotics to treat infection.
  • Fluid infusion to prevent and treat dehydration.
  • Cream or ointment to apply on the infected skin area.
  • Especially for babies who suffer from SSSS will be treated in an incubator.

After treatment, the healing process of SSSS takes 1-2 days. Patients usually recover completely in 5-7 days.

Complications of Staphylococcal Scalded Skin Syndrome (SSSS)

If treated properly, SSSS can heal completely without leaving scars. On the other hand, untreated SSSS can lead to a number of complications, such as the following:

  • Dehydration.
  • Scar.
  • Cellulitis or deeper skin tissue infection.
  • Pneumonia or lung infection.
  • Bacteremia.
  • Sepsis.
  • Shock.

Prevention of Staphylococcal Scalded Skin Syndrome (SSSS)

SSSS disease is difficult to prevent. However, there are a number of ways to prevent transmission, for example by treating people with SSSS as soon as possible. Another way of prevention is to apply clean living habits, namely by regularly washing hands, especially when in areas prone to infection transmission, such as child care.