childhood rashes

Question 1

Chickenpox (varicella)

Answer 1

Vesicles (papules)
Appear as drops of water
First appears on face and scalp then spreads to extremities
Crusts fall of in 1-3 weeks, leaving a pink base
*fever
*dyspnea/cough could indicate varicella-zoster virus

• exclude from school until lesions have crusted over

Question 2

Impetigo

Answer 2

Itchy lesions
Macules, vesicles, bullae, pustules
Gold crust is caused by Staphyloccous aureus / group A Beta Hemolytic Streptococci
First line tx fusidic acid then fluclox

• exclude from school until 48 hour after abx and/or lesions ahve crusted over

Question 3

Steven Johnson Syndrome

Answer 3

Rash, macules
Develop in papules, vesicles, bullae, urticarial plaques, confluent erythema
Center of the lesion may be vesicular, purpuric or necrotic

Question 4

Meningococcal Meningitis

Answer 4

2-10mm macular or maculopapular rash
Sparsely distributed on the face, trunk and lower extremities
Blanches on pressure
Petechiae in the center of the macules becomes haemorrhagic (do not blanche)
Glass test

Question 5

HSV

Answer 5

Eczema herpeticum (right picture)– not to be confused with dermatitis hepetiformitis (left picture) which can occur in coeliac
Often mild
Eczema causing an eruption of crusty vesicles