RT Book, Section
A1 Shah, Ashish
A1 Sobolewski, Brad
A1 Mittiga, Matthew R.
A2 Knoop, Kevin J.
A2 Stack, Lawrence B.
A2 Storrow, Alan B.
A2 Thurman, R. Jason
SR Print(0)
ID 1181044438
T1 Staphylococcal Scalded Skin Syndrome
T2 The Atlas of Emergency Medicine, 5e
YR 2021
FD 2021
PB McGraw-Hill
PP New York, NY
SN 9781260134940
LK accessmedicine.mhmedical.com/content.aspx?aid=1181044438
RD 2024/04/23
AB Staphylococcal  scalded  skin  syndrome  (Ritter  disease)  most  commonly  affects  infants  and  children  less  than  5  years  of  age  and  is  caused  by  an  exfoliative  exotoxin-producing  strain  of  S  aureus.  Initial  presentation  includes  fever,  malaise,  and  irritability  following  an  upper  respiratory  infection  with  pharyngitis  or  conjunctivitis.  Patients  first  develop  a  diffuse  faint  blanching  erythematous  rash  that  is  tender  to  the  touch.  Crusting  around  the  mouth,  eyes,  and  neck  may  be  seen.  Within  2  to  3  days,  flaccid  blisters  and  bullae  develop,  especially  in  flexor  creases  and  the  buttocks,  hands,  and  feet.  These  bullae  are  sterile.  In  some  patients,  widespread  desquamation  occurs.  The  differential  diagnosis  includes  toxic  epidermal  necrolysis,  exfoliative  erythroderma,  bullous  erythema  multiforme,  bullous  pemphigoid,  bullous  impetigo,  sunburn,  enterovirus,  drug  reaction  with  eosinophilia  and  systemic  symptoms  (DRESS)  syndrome,  acute  mercury  poisoning,  toxic  shock  syndrome,  and  epidermolysis  bullosa.