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Staphylococcal scalded skin syndrome: An epidemiological and clinical review of 84 cases

Carmen Liy-Wong1, Elena Pope1, Miriam Weinstein1

  • 1Division of Pediatric Medicine, Section of Dermatology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.

Pediatric Dermatology
|December 7, 2020
PubMed

Insights

Staphylococcal scalded skin syndrome (SSSS) in children often presents with erythema and exfoliation. Avoid surgical debridement, as it increases complications, and clindamycin shows no benefit in reducing hospitalization for pediatric SSSS.

Area of Science:

  • Pediatric Dermatology
  • Infectious Diseases
  • Clinical Epidemiology

Background:

  • Staphylococcal scalded skin syndrome (SSSS) is a toxin-mediated blistering disorder primarily affecting infants and children.
  • Limited literature exists on the specific characteristics and management of pediatric SSSS.
  • This study aims to detail the epidemiology, clinical presentation, and treatment outcomes of SSSS in a pediatric population.

Purpose of the Study:

  • To describe the epidemiology of pediatric Staphylococcal scalded skin syndrome (SSSS).
  • To outline the clinical features and common symptoms of SSSS in children.
  • To evaluate the management strategies and outcomes for pediatric SSSS cases.

Main Methods:

  • A retrospective cohort study was conducted.
  • Included pediatric patients with a clinical diagnosis of SSSS from January 1994 to March 2016.
  • Data collected on demographics, clinical presentation, microbiology, and treatment outcomes.

Main Results:

  • Eighty-four pediatric patients were included, with 58% being male, mean age 3.1 years.
  • Erythema and exfoliation were universal; vesicles/bullae occurred in 76%. Skin tenderness was most common (81%).
  • Mean hospitalization was 4.7 days; surgical debridement was linked to complications and longer stays. Clindamycin did not alter admission duration.

Conclusions:

  • Healthcare providers should consider SSSS in pediatric differential diagnoses for erythema and blistering.
  • Periorificial swabs were more likely to yield Staphylococcus aureus, but toxin testing is needed for confirmation.
  • Antibiotic choices should be based on sensitivity. Clindamycin's anti-toxin role needs further investigation. Surgical debridement should be avoided.
Abstract

Keywords:
Staphylococcal scalded skin syndromeantibioticspediatricsskin infections

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