Staphylococcal scalded skin syndrome (SSSS), or Ritter disease, is an acute disease caused by epidermolytic toxins released by strains of Staphylococcus aureus. Newborns are particularly susceptible to these exfoliative toxins. Oftentimes, focal infection of the nasopharynx, conjunctivae, perineum, or umbilicus produces toxins that lead to diffuse fragile bullae, which are often no longer intact at the time of presentation. However, any systemic or cutaneous infection with epidermolytic toxin-producing S. aureus may induce SSSS. Infants are believed to have increased susceptibility to SSSS due to lack of neutralizing antibodies and decreased renal capacity for toxin excretion.

In the newborn, presentation generally occurs between 3-7 days of life, with only one reported case of congenital SSSS. Symptoms occur acutely, with sudden onset of fever, irritability, cutaneous tenderness, and characteristic cutaneous eruption. Symptoms of SSSS can occur in conjunction with bullous impetigo. Full recovery occurs in most cases. Sepsis (with multisystemic involvement) and fluid and electrolyte abnormalities are possible.