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what is staphylococcal scaled skin syndrome (SSSS) caused by?
a type of staph aureus that produces epidermolytic toxins
what are the epidermolytic toxins?
protease enzymes that break down proteins that hold skin cells together
which ages does SSSS generally affect and why?
under 5s - older children and adults have developed immunity to epidermolytic toxins
what are the features of the rash in SSSS?
- starts with generalised patches of erythema on the skin (looks thin and wrinkled)
- then forms bullae which burst and end up looking like a scald/burn

what is the nikolsky sign?
gentle rubbing of the skin causes it to peel away
what are the other symptoms of SSSS?
- fever
- irritability
- lethargy
- dehydration
what is the management of SSSS?
- admission and treatment with IV antibiotics
- fluid and electrolytes