Health Information

Scalded skin syndrome

Scalded skin syndrome


Ritter disease; Staphylococcal scalded skin syndrome (SSS)

Scalded skin syndrome is a skin infection in which the skin becomes damaged and sheds.

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  • Causes

    Scalded skin syndrome is caused by infection with certain strains of Staphylococcus bacteria. The bacteria produce a poison that causes the skin damage. The damage creates blisters, as if the skin were scalded. These blisters can occur at areas of the skin away from the initial site.

    Scalded skin syndrome is found most commonly in infants and children under the age of 5.

  • Symptoms

    • Blisters
    • Fever
    • Large areas of skin peel or fall away (exfoliation or desquamation)
    • Painful skin
    • Redness of the skin (erythema), which spreads to cover most of the body
    • Skin slips off with gentle pressure, leaving wet red areas (Nikolsky's sign)
  • Exams and Tests

    The health care provider will perform a physical exam and look at the skin. The exam may show that the skin slips off when it is rubbed (positive Nikolsky's sign).

    Tests may include:

    • Complete blood count (CBC)
    • Cultures of the skin, throat, nose and blood
    • Electrolyte test
    • Skin biopsy (in rare cases)
  • Treatment

    Antibiotics are given through a vein (intravenously) to help fight the infection. Fluids are also given through a vein to prevent dehydration. Much of the body's fluid is lost through open skin.

    Moist compresses to the skin may improve comfort. You can apply a moisturizing ointment to keep the skin moist. Healing begins about 10 days after treatment.

  • Outlook (Prognosis)

    A full recovery is expected.

  • Possible Complications

    • Fluid regulation problems causing dehydration or electrolyte imbalance
    • Poor temperature control (in young infants)
    • Severe bloodstream infection (septicemia)
    • Spread to deeper skin infection (cellulitis)
  • When to Contact a Medical Professional

    Call your health care provider or go to the emergency room if you have symptoms of this disorder.

  • Prevention

    The disorder may not be preventable. Treating any staphylococcus infection quickly can help.

Related Information

  FeverSkin blushing/flus...SepticemiaCellulitis    


Staphylococcal Scalded Skin Syndrome (Ritter Disease). In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 657.3.


Review Date: 11/20/2013  

Reviewed By: Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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