[Staphylococcal scalded skin syndrome: a pediatric dermatology emergency]

Staphylococcal scalded skin syndrome (SSSS) is a rare, toxin-mediated skin disorder of childhood, caused by the exfoliative toxins ETA and ETB released by Staphylococcus aureus. We report on a 4-year-old boy who presented with a 5-day history of painful, progressive blistering of the face, trunk and anogenital region. Clinical examination revealed widespread erythema with coarse lamellar desquamation, flaccid blisters and a positive Nikolsky sign; the mucous membranes were spared, an important feature distinguishing SSSS from toxic epidermal necrolysis and Stevens-Johnson syndrome. Under parenteral flucloxacillin and clindamycin combined with antiseptic wound care and supportive treatment, the skin healed completely within 1 week. Because delayed treatment can substantially increase mortality, prompt recognition of SSSS and the immediate initiation of empirical antibiotic therapy are decisive for prognosis.