Dukes' disease, named after Clement Dukes (1845–1925),[1][2] also known as fourth disease,[3] Filatov-Dukes' disease (after Nil Filatov),[4] Staphylococcal Scalded Skin Syndrome (SSSS),[5] or Ritter's disease[6] is an exanthem (rash-causing) illness primarily affecting children and historically described as a distinct bacterial infection, though its existence as a separate disease entity is now debated.
It is distinguished from measles or forms of rubella, though it was considered as a form of bacterial rash.[3] Although Dukes identified it as a separate entity, it is thought not to be different from scarlet fever caused by exotoxin-producing Streptococcus pyogenes after Keith Powell proposed equating it with the condition currently known as staphylococcal scalded skin syndrome in 1979.[3][7]
It was never associated with a specific pathogen,[8] and the terminology is no longer in use.[3] However, a mysterious rash of unknown cause in school children often gives rise to the question of whether it could be Dukes' disease.[9]