CIS: Skin changes in blood and lymph Flashcards
What are causes of a Diffuse Maculopapular Rash?
- Measles
- Rubella
- Erythema Infectiosum
- Infectious mononucleosis
- Lyme disease
Describe Measles
- Exposure: day 1
- 7-18 days later: prodrome in an unvaccinated patient (fever, cough, coryza, conjunctivis)
- 3-4 days after prodrome: brick red maculopapular rash “morbiliform rash” that begins on the face and proceeds “downward and outward” => palms and soles LAST. Lasts 3-5 days
- Koplik spots on buccal mucosa = pathognomonic
What is pathognomic for measles
Koplik spots = but only occur
What are complications of measles?
- Pneumonia
- Post-measles encephalitis
How is the presentation of Rubella different from Measles?
“3 day measles”
Short prodrome and rash only lasts 2-3 days.
What is fifth disease and who does it occur in?
- Fifth disease => erythema infectionisum => due to parvovirus B19
- Produces a slapped cheek appearance
- White around mouth (circumoral pallor)
- Lacy, maculopapular rash on TRUNK and LIMBS
- Itchy palms and soles
- Little fever
What is the presentation of erythema infectiosum?
- Child + red “slapped cheek appearce”
- White around mouth “circumoral pallor”
- Lacy maculopapular rash on the trunk and limbs
- Pruritis in palms and soles
- Rarely fever

Parvovirus is one the most common causes of _____ in children.
What else can it cause?
Myocarditis
=> aplastic crisis and pure RBC aplasia
How does parvovirus affect middle aged people (especially women)?
Mimics SLE and RA => looks like an inflammatory arthritis

What lesion does Lymes Disease produce?
Erythema migrans: flat or slightly raised expanding lesion where tick bit => progresses to a bulls-eye lesion (becomes pale in the middle)

What are the stages of Lymes Disease?
Where is it MC?
NE, Mid-Atlantic, Upper Midwest, Pacific coast
- Stage 1 (early localized infection): Erythema migrans “bulls eye lesion” + myalgias + HA/fatigue
-
Stage 2: Early disseminated infections (weeks - months later)
- Bacteremia
- Secondary lesions (similar to 1st but smaller)
- Stage 3: Late persistant infections (months - years): MSK infections => monoarticular, oligoarticular arthritis of knee or weight bearing joints

How is the maculopapular rash + vesicle formation seen in Lymes different than shingles?
Does NOT follow a dermatomal distrubution

Infectious mononucleosis if the MC manifestation of EBV.
- How is it transmitted?
- What is the incubation period?
- MC at what ages?
Infectious mononucleosis if the MC manifestation of EBV.
- How is it transmitted?
- What is the incubation period?
- MC at what ages?
- Saliva
- 30-50 days
- 12-19 YO
Other symptoms of infectious mononucleosis
Diagnose how?
- Fever + malaise
- Exudative sore throat: pharyngitis, uvular edema, tonsilittis, gingivitis
- Posterior cervical lymphandenopathy
Dx = (+) heterophile aggluttination test (monospot)
What are common illnesses that manifest with manifest with peripheral skin eruptions?
- Meningococcemia
- Rocky Mountain Spotted Fever
- Secondary syphilis
- Hand/Foot/Mouth disease
Rocky Moutain Spotted Fever
- MC caused by
- When does it occur
- Complication?
- Rickettsia rickettssi, a parasite of tick, caused by ticks
- Late spring - summer
- If untreated= 70% chance of mortality
Descibe the rash and presentattion of RMSF
- Cough + pneumonitis
- Rash = begins as a faint macule that progresses to large maculopapules/petchiae; begins on wrist and ankles (can involve palms and soles) => spreads to arms, legs and trunk
What causes Syphilis?
Treponema pallidum, a spirochete, via sexual contact
2 major clinical stages of syphilis
1. Early (infectious stage)
2. Late syphilis