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    Scalded skin syndrome

    Ritter disease; Staphylococcal scalded skin syndrome (SSS)

    Scalded skin syndrome is a skin infection in which the skin becomes damaged and sheds.

    Causes

    Scalded skin syndrome is caused by infection with certain strains of Staphylococcus bacteria. The bacteria produce a poison that causes the skin damage. The damage creates blisters as if the skin were scalded.

    Scalded skin syndrome is found most commonly in infants and children under the age of 5.

    Symptoms

    • Blisters
    • Fever
    • Large areas of skin peel or fall away (exfoliation or desquamation)
    • Painful skin
    • Redness of the skin (erythema), which spreads to cover most of the body
    • Skin slips off with gentle pressure, leaving wet red areas (Nikolsky's sign)

    Exams and Tests

    The health care provider will perform a physical exam and look at the skin. The exam may show that the skin slips off when it is rubbed. This is called a positive Nikolsky's sign.

    Tests may include:

    • Complete blood count (CBC)
    • Cultures of the skin and throat
    • Electrolyte test
    • Skin biopsy (in rare cases)

    Treatment

    Antibiotics are given through a vein (intravenously) to help fight the infection. Fluids are also given through a vein to prevent dehydration. Much of the body's fluid is lost through open skin.

    Moist compresses to the skin may improve comfort. You can apply a moisturizing ointment to keep the skin moist. Healing begins about 10 days after treatment.

    Outlook (Prognosis)

    A full recovery is expected.

    Possible Complications

    • Fluid regulation problems causing dehydration or electrolyte imbalance
    • Poor temperature control (in young infants)
    • Severe bloodstream infection (septicemia)
    • Spread to deeper skin infection (cellulitis)

    When to Contact a Medical Professional

    Call your health care provider or go to the emergency room if you have symptoms of this disorder.

    Prevention

    The disorder may not be preventable. Treating any staphylococcus infection quickly can help.

    References

    Morelli JG.Staphylococcal Scalded Skin Syndrome (Ritter Disease).In: Kliegman RM,Behrman RE, Jenson HB, Stanton BF, eds.Nelson Textbook of Pediatrics.19th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 657.3.

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              Tests for Scalded skin syndrome

                Review Date: 12/6/2011

                Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School, Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

                The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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                St. Luke's Hospital - 232 South Woods Mill Road - Chesterfield, MO 63017 Main Number: 314-434-1500 Emergency Dept: 314-205-6990 Patient Billing: 888-924-9200
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