| Staphylococcal scalded skin syndrome | |
|---|---|
| Classification and external resources | |
| ICD-10 | L00 |
| ICD-9 | 695.81 |
| DiseasesDB | 29437 |
| eMedicine | derm/402 emerg/782 |
| MeSH | D013206 |
Staphylococcal scalded skin syndrome, SSSS, also known as Pemphigus neonatorum[1] or Ritter's disease,[1] or Localized bullous impetigo is a dermatological condition caused by Staphylococcus aureus.
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The syndrome is induced by epidermolytic exotoxins (exfoliatin)[2] A and B, which are released by S. aureus and cause detachment within the epidermal layer. One of the exotoxins is produced by the bacterial chromosome, while the other is produced by a plasmid. (Bacterial plasmids are pieces of self-replicating DNA that often code for secondary characteristics, such as antibiotic resistance, and toxin production.) These exotoxins are proteases that cleave desmoglein-1, which normally holds the granulosum and spinosum layers together.
The disease presents with the widespread formation of fluid filled blisters that are thin walled and easily ruptured and the patient can be positive for Nikolsky's sign. Ritter's Disease of the Newborn is the most severe form of SSSS with similar signs and symptoms.
The clinical features were first described in 1878 by Baron Gottfried Ritter von Rittershain, who observed 297 cases among children in a single Czechoslovakian children's home over a 10-year period.[3]
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