Staphylococcal scaled skin syndrome (SSSS) is an exfoliating skin disease that predominantly affects newborns and young children. This infectious exanthema, characterized by superficial epidermis detachment, is due to Staphylococcus aureus infection excreting exfoliative toxins A and/or B. This case report illustrates the clinical signs of SSSS characterized by an erythrodermic and blistering skin rash with erythematous and oozing lesions in friction areas. The diagnosis of SSSS was clinically established. A positive evolution was observed under intravenous antibiotic treatment with flucloxacillin and clindamycin associated with movicol®, local care, and hydro-electric re-equilibration.
We have addressed the physiopathology and differential diagnosis of SSSS, highlighting the relevance of early diagnosis. Then, we have discussed guidelines about the treatment/management, and particularly the benefits of combining clindamycin and an osmotic laxative, infusion of fresh frozen plasma, or intravenous immunoglobulins in case of antibiotic resistance.
Key Words
Staphylococcal scaled skin syndrome (SSSS), exfoliative skin disease, adolescent, bullous, exfoliative toxins, clindamycin
What is already known about the topic?
- Staphylococcal scaled skin syndrome is an exfoliating skin disease caused by Staphylococcus aureus infection excreting exfoliative toxins A and/or B.
- The disease mostly affects newborns and young children prior to the age of 10, as well as adults with immunodeficiency or renal disease.
- The diagnosis of SSSS is clinically established.
- Treatment consists of intravenous anti-staphylococcal antibiotics.
What does this article bring up for us?
- This article informs us about the role and stages required to rapidly recognize the clinical manifestations in order to establish an early SSSS diagnosis, while illustrating the clinical presentation of the adolescent phenotype.
- Based on a literature review, the article details the SSSS physiopathology, differentiates SSSS from toxic epidermal necrolysis (TEN) or bullous impetigo, presents the management guidelines, and discusses the benefits of including clindamycin and an osmotic laxative, or of infusing fresh frozen plasma or intravenous immunoglobulins in the case of antibiotic resistance.