SSSS in Pediatric Patients: Is Early Recognition Always Straightforward?

Abstract

Staphylococcal Scalded Skin Syndrome (SSSS) is a rare bullous dermatosis caused by staphylococcal exfoliative toxins, predomi-nantly affecting children under six years of age. A six-year-old boy developed intense erythema and facial edema while camping, following recent impetigo. The initial presentation included pe-ri-orificial erythema, hyperemic lips, and conjunctivitis without fever. Within 48 hours, desquamation, bullae, and a positive Nikolsky sign developed. Treatment with clindamycin resulted in rapid clinical improvement. The camping setting initially sugge-sted sunburn; however, the characteristic peri-orificial distribution and positive Nikolsky sign confirmed the diagnosis of SSSS. This case highlights the importance of considering SSSS in pediatric bullous eruptions following staphylococcal infections. Although rare, SSSS requires prompt recognition and appropriate antibiotic therapy. Clinicians should maintain high suspicion for SSSS in pediatric patients with acute bullous lesions, even when clinical settings suggest alternative diagnoses.