A case report: Staphylococcal scalded skin syndrome in a minor infant

  • Maricarmen Chacín Centro de Investigaciones Endocrino - Metabólicas “Dr. Félix Gómez”, Facultad de Medicina Universidad del Zulia
  • Valmore Bermúdez Grupo de Investigación Altos Estudios de Frontera (ALEF), Universidad Simón Bolívar
  • Basilio Bucete Hospital de Especialidades Pediátricas
  • Joselyn Rojas Department of Pulmonary and Critical Care Medicine, Brigham and Women’s Hospital, Harvard Medical School
Keywords: Staphylococcus aureus, exfoliatin, Chikungunya fever, neonatal exfoliative dermatitis


Staphylococcal scald skin syndrome is an entity first described by Ritter Von Rittershain in 1878, which was called neonatal exfoliative dermatitis. This situation belongs to a group of pathologies caused by toxins produced by Staphylococcus aureus, called exfoliate A and B, which are characterized by a wide range of segmental lesions and degeneration. It is not a common pathology, but it most often occurs in newborns and children under the age of 5. This study describes a clinical case of a minor baby transferred to the emergency room by his mother, characterized by a systemic rash followed by follicle lesions, which is consistent with the Chikungunya fever (ChikV) outbreak reported in Maracaibo since June 2014.


Lowy FD. Staphylococcus aureus infections. N Engl J Med 1998; 339(8): 520–532.

Tuazon CU, Pérez A, Kishaba T, Sheagren JN. Staphylococcus aureus among insulin-injecting diabetic patients: An increased carrier rate. JAMA 1975; 231(12): 1272.

Tuazon CU, Sheagren JN. Increased rate of carriage of Staphylococcus aureus among narcotic addicts. J Infect Dis 1974; 129(6): 725–727.

Von Rittershain RG. Dermatitis of young infants (in Spanish). Zentralzeitung fur Kinderheilkunde 1878; 2: 3.

Li MY, Hua Y, Wei GH, Qiu L. Staphylococcal scalded skin syndrome in neonates: An 8-year retrospective study in a single institution. Pediatr Dermatol 2014; 31(1): 43–7.

Herbst A, Morgan MB. Staphylococcal toxin-mediated scalded skin and toxic shock syndromes. In: Crowe D, Morgan M, Somach S, Trapp K (editors). Deadly dermatologic diseases. Springer; 2016.

Lyell A. The staphylococcal scalded skin syndrome in historical perspective: Emergence of dermopathic strains of Staphylococcus aureus and discovery of the epidermolytic toxin. A review of events up to 1970. J Am Acad Dermatol 1983; 9(2): 285–294.

Handler MZ, Schwartz RA. Staphylococcal scalded skin syndrome: diagnosis and management in children and adults. J Eur Acad Dermatol Venereol 2014; 28(11): 1418–1423.

Amagai M, Matsuyoshi N, Wang ZH, Andl C, Stanley JR. Toxin in bullous impetigo and staphylococcal scalded skin syndrome targets desmoglein 1. Nat Med 2000; 6(11): 1275–1277.

Nikolski PV. K.uchenigu materials on pemphigus foliaceus (in Spanish) [PhD thesis]. Kiev; 1896.

Moss C, Gupta E. The Nikolsky sign in staphylococcal scalded skin syndrome. Arch Dis Child 1998; 79(3): 290.

Hoffmann R, Lohner M, Böhm N, Schaefer H-E, Leititis J. Staphylococcal scalded skin syndrome (SSSS) and consecutive septicaemia in a preterm infant. Pathology - Research and Practice 1994; 190(1): 77–81.

Sethuraman KM, Avabratha KS, Varghese AD, Rai BS. Staphylococcal scalded skin syndrome: A dermatological emergency in pediatrician’s hand. Medical Journal of Dr. D.Y. Patil University 2014; 7(2): 189–191. doi: 10.4103/0975-2870.126336.

Ladhani S, Robbie S, Garratt RC, Chapple DS, Joannou CL, et al. Development and Evaluation of Detection Systems for Staphylococcal Exfoliative Toxin a Responsible for Scalded-Skin Syndrome. Journal of Clinical Microbiology 2001; 39(6): 2050–2054. doi: 10.1128/JCM.39.6.2050-2054.2001.

Sakurai S, Suzuki H, Machida K. Rapid identification by polymerase chain reaction of staphylococcal exfoliative toxin serotype A and B genes. Microbiology and Immunology1995; 39: 379–386. doi: 10.1111/j.1348-0421.1995.tb02216.x.

Nso Roca AP, Baquero-Artigao F, García-Miguel MJ, Benito Caldés C, José Gómez MI de, et al. Neonatal staphylococcal scalded skin syndrome. Acta Pediatr Esp 2007; 65(7): 327–329.

Case Reports