• A Horna Strand, S Rubertsson, F Huss, and M Mani.
• Burn Center, Department of Plastic- and Maxillofacial Surgery, Uppsala University Hospital, 751 85 Uppsala, Sweden. Electronic address: angelica.horna.strand@akademiska.se.
• Burns. 2016 Mar 1; 42 (2): e18-23.

AbstractThis report concerns an 18-month-old boy who presented with a 6% total body surface area scald. The subject of this report is unique in that he developed the largest exfoliation described in literature. After 3 days an epidermal exfoliation with the appearance of a deliberately inflicted scald developed. As the exfoliation progressed to over 95% total body surface area the suspicion of child abuse or neglect could be abandoned. The diagnosis Staphylococcal scalded skin syndrome was set, due to the finding of Staphylococcus aureus on swabs, the lack of mucosal engagement, and the patient's age. The boy's skin healed within 3 weeks. The few reports published are all case reports and most frequently described visually infected burns with smaller epidermal exfoliations, and clinically based exfoliation diagnosis. S. aureus often cause burn wound infections that can lead to complications caused by cross-infection. It is important for burn surgeons and intensive care specialists to be aware of the increased possibility of Staphylococcal scalded skin syndrome occurring in patients who have a reduced barrier to infection such as burn patients and also, that the diagnosis can be difficult to make. Copyright © 2016. Published by Elsevier Ltd.

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