Enteral nutrition must be commenced if oral intake is not possible.If pain is severe, an opioid infusion is preferred to non-steroidal anti-inflammatory drugs (NSAIDs) because the damaged skin is already prone to bleeding and renal excretion of the exotoxins makes maximised renal function important. Moist, bare areas should be lubricated with a bland emollient to alleviate pruritus and tenderness.
Supportive care and appropriate attention to fluid and electrolyte management usually ensure rapid recovery. It is painful and distressing for the patient and parents, although most cases respond to antibiotic treatment. As a result there is likely to be a spectrum of disease and there are likely to be a number of milder cases of adult SSSS that go undiagnosed. There appears to be a relationship between the disease extent, the amount of toxin produced and whether the toxin is released locally or systemically. Some consider bullous impetigo to be a type of SSSS. The same toxins that are responsible for causing SSSS also cause bullous impetigo. In SSSS the superficial epidermis becomes detached. They break the epidermal cell adhesion molecule, desmoglein 1, breaking up the skin by preventing skin cells sticking to each other. These are serine proteases which are spread by the circulation from a localised source, causing widespread epidermal damage at distant sites. They cause skin damage by releasing epidermolytic toxins. Most commonly it is caused by those belonging to phage group II (types 3A, 3B, 3C, 55, or 71) but occasionally to groups I and III. It can also be known as Ritter's disease. SSSS is a disease characterised by red, blistered skin, which resembles a burn or a scald, hence the name. aureus may also cause a number of toxin-mediated, potentially life-threatening diseases, including staphylococcal scalded skin syndrome (SSSS). This is one of the most common causes of skin infection, giving rise to folliculitis, impetigo, cellulitis and abscesses. It can, however, predispose to infection, particularly when the bacteria have an opportunity to break through the skin. Staphylococcus aureus is a bacterium commonly found harmlessly colonising human skin and mucosa without causing any morbidity.
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