By Gary M. White, MD

staphylococcal scalded skin syndrome Courtesy James Rasmussen, MD

Staphylococcal scalded skin syndrome (SSSS) is a localized infection by coagulase-positive group II Staphylococcus aureus (especially strain 71) that causes diffuse skin changes mediated via the release of a toxin.


The face is often covered with crust like an impetigo pie. A very superficial and thin layer of the skin may slough off. This is particularly common on the neck, and axilla. Thin-walled bulla may form.


The patient is usually hospitalized. IV antistaphylococcal antibiotics are in order. Supportive care including temperature regulation, fluid management (rehydration), nutrition, and skin care should be considered. Corticosteroids are contraindicated. Pain management is usually necessary and opioids are commonly needed. Complications such as pneumonia and sepsis may occur, but are rare.

Additional Pictures

staphylococcal scalded skin syndrome staphylococcal scalded skin syndrome

staphylococcal scalded skin syndrome staphylococcal scalded skin syndrome
Note the prominent perioral involvement.


Indian Pediatr 2012;49: 853-854
SSS resembling TEN. Case Reports in Dermatological MedicineVolume 2015 (2015), Article ID 901968,


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