TY - CHAP M1 - Book, Section TI - Staphylococcal Scalded Skin Syndrome A1 - Shah, Ashish A1 - Sobolewski, Brad A1 - Mittiga, Matthew R. A2 - Knoop, Kevin J. A2 - Stack, Lawrence B. A2 - Storrow, Alan B. A2 - Thurman, R. Jason Y1 - 2021 N1 - T2 - The Atlas of Emergency Medicine, 5e AB - Staphylococcal scalded skin syndrome (Ritter disease) most commonly affects infants and children less than 5 years of age and is caused by an exfoliative exotoxin-producing strain of S aureus. Initial presentation includes fever, malaise, and irritability following an upper respiratory infection with pharyngitis or conjunctivitis. Patients first develop a diffuse faint blanching erythematous rash that is tender to the touch. Crusting around the mouth, eyes, and neck may be seen. Within 2 to 3 days, flaccid blisters and bullae develop, especially in flexor creases and the buttocks, hands, and feet. These bullae are sterile. In some patients, widespread desquamation occurs. The differential diagnosis includes toxic epidermal necrolysis, exfoliative erythroderma, bullous erythema multiforme, bullous pemphigoid, bullous impetigo, sunburn, enterovirus, drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome, acute mercury poisoning, toxic shock syndrome, and epidermolysis bullosa. SN - PB - McGraw-Hill CY - New York, NY Y2 - 2024/03/28 UR - accessemergencymedicine.mhmedical.com/content.aspx?aid=1181044438 ER -