Staphylococcal scalded skin syndrome is a rare staphylococcal toxin–mediated exfoliative dermatitis. With an estimated incidence of 0.09 to 0.13 cases per 1 million people, 98% of cases occur in children aged 6 years or younger, with a mortality rate of 4% to 11%. Lack of mucosal involvement and a positive Nikolsky’s sign (pressure to apparently normal skin separating the outer epidermis) enables differentiation from similar conditions such as toxic epidermal necrolysis. Treatment generally includes a β-lactamase–resistant penicillin and consideration of methicillin-resistant Staphylococcus aureus, but clindamycin may also inhibit toxin formation. Complete healing typically occurs without significant scarring. Source: Ann Emerg Med. 2013;61:118.

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