Staphylococcal Scalded Skin Syndrome (SSSS) 

(aka Ritter disease) 

Nikolsky positive 

Clinical 

• Typically occurs 3 to 7 days of age 

• Rare at birth 

• Fever, irritable 

• Erythroderma (often begins around mouth) 

• Blisters appear in areas of mechanical stress (flexural areas, buttocks, hands, feet) 

• Conjunctivitis 

Management 

• Supportive 

• Nafcillin or oxacillin (or any anti-staphylococcal) 

• Vancomycin (if high prevalence of CA-MRSA or initial treatment failure) 



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