Rash
Rash
Exanthem
Infection
Inflammation
Exanthem
Infection
- 1st: Measles (Measles virus)
- Prodrome: 2-4d prior to rash - fever, malaise, anorexia then non purulent conjunctivitis, coryza, and cough
- Enanthem: 48h prior rash - Koplik spots 1 to 3 mm whitish, grayish, or bluish elevations with an erythematous base ("grains of salt on a red background") typically on the buccal mucosa opposite the molar teeth.
- erythematous, maculopapular, blanching rash, starting on face > neck > trunk > limbs, can become petechial
- lymphadenopathy, fever continues peaking 48h after appearance of rash), Uncommonly, patients with severe measles develop generalized lymphadenopathy and splenomegaly
- 2nd: Scarlet fever aka Scarlatina (GAS)
- Diffuse blanching erythematous rash with small (1 to 2 mm) papular elevations giving "sandpaper" feel
- Starts in groin and arm pits
- Circumoral pallor and strawberry tongue
- 3rd: Rubella aka German Measles (Rubella virus)
- ?Prodrome: Low grade fever and lymphadenopathy (post cervical, post auricular, and suboccipital) 5 days prior to D0 rash
- Acute onset of a maculopapular rash with minimal systemic symptoms
- pinpoint, pink maculopapules starting on face > torso > limbs
- can have nonexudative conjunctivitis, arthritis, orchitis, thyroiditis, and enanthem on soft palate (Forchheimer spots)
- Panencephalitis rare
- (?4th: Dukes' disease)
- 5th: Slapped Cheek aka Erythema infectiosum (ParvoB19)
- prodrome: fever, coryza, headache, nausea, diarrhea
- 2-5 days later: malar rash appears with relative circumoral pallor
- days later: reticulated (lacey) rash to trunk and limbs
- reticulocytopenia, leukopenia, thrombocytopenia
- 6th: Roseola infants aka 3 day fever (HHV6 > 7 > entero (coxsackie A/B, echo), adeno, and paraflu1)
- 3-5 days of high fever, sudden resolution, then rash
- erythematous, blanching, macular or maculopapula
- torso then face/extremities
- neutropenia, atypical lymphocytosis, thrombocytopenia, sterile pyuria
- Varicella aka Chicken pox
- Acute rheumatic fever
- Kawasaki's
- Urticaria
- Erythema multiforme
- Stevens Johnson
- Hand foot and mouth
- Erysipelas
- Impetigo aka School sores
- Ring worm
- Gianotti-Crosti syndrome aka Papular acrodermatitis
- Usually not pruritic
Inflammation
- SLE
- HSP