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April 1992

Picture of the Month

Author Affiliations

Contributed from the Department of Pediatrics, Division of Neonatology, University of Cincinnati (Ohio) Medical Center.

Am J Dis Child. 1992;146(4):425-426. doi:10.1001/archpedi.1992.02160160045011

Denouement and Discussion 

Ritter's Disease (Neonatal Staphylococcal Scalded Skin Syndrome) 

Historical Background  Baron Gotfried Ritter von Rittershain was the first to describe this dramatic exfoliative disease of newborns, having done so in 1878.1 During a 10-year period, 297 cases occurred in the orphanage in Prague, Czechoslovakia, where he served as physician. He labeled the disorder dermatitis exfoliativa neonatorum, but was unsure of its cause. In 1956, Lyell2 renewed attention to this striking disorder, which he described as resembling scalding. Not until 1970, however, did Melish and Glasgow3 demonstrate in newborn mice that Staphylococcus aureus, particularly

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