DERM 08: Viral Exanthems Flashcards
What are enanthems?
eruption/rash on mucous membrane caused by infection (usually viral) or medication reactions
What are exanthems?
skin rash accompanying disease or fever caused by infection or medications
- widespread, appears abruptly, affects several areas at same time, morbiliform or maculopapular
- more common in children
What are the exanthem diseases?
- 1st: measles (rubeola)
- 2nd: scarlet fever
- 3rd: rubella
- 4th: duke’s disease
- 5th: erythema infectiosum
- 6th: roseola (exanthema subitum)
1st Disease: Measles (Rubeola)
- Pathogen
- Contagious
- paramyxovirus
- contagious – 1-2 days before onset of symptoms, to 4 days after appearance of rash
2nd Disease: Scarlet Fever
- Pathogen
- streptococcus pyogenes (group A strep)
3rd Disease: Rubella (German measles or ‘3-day measles)
- Pathogen
- Contagious
- togavirus
- contagious
4th Disease: Duke’s Disease
no longer accepted as distinct disease
5th Disease: Erythema Infectiosum
- Pathogen
- Contagious
- parvovirus B19
- contagious before onset of rash
6th Disease: Roseola (Exanthema Subitum)
- Pathogen
- Contagious
- human herpesvirus type 6 (HHV-6) and 7 (HHV-7)
- less common: enterovirus, adenovirus, parainfluenza type 1
- not contagious
What is measles spread by?
respiratory droplets
What are the signs and symptoms of measles?
- high fever, malaise, conjunctivitis, cough, ‘head cold’
- enanthem: koplik spots
- exanthem: erythematous macules and papules – not itchy, red/pink, purple, or darker than
What is the treatment for measles?
- antipyretics (acetaminophen 15 mg/kg q6h PRN, or ibuprofen 10 mg/kg q8h PRN)
- fluids
- rest
What is the recovery time for measles?
- rash 6-7 days
- clinical signs and symptoms 2 days after rash appears
- total duration is approximately 2 weeks
What are the preventative measures for measles?
- vaccinations
- avoid others until min. 5 days after rash onset
How is rubella spread?
through direct or respiratory droplets
When is rubella shed?
shed virus 1 week prior, and 2 weeks post-onset of disease
What are the signs and symptoms of rubella?
- rash appears 14-17 days after exposure
- low-grade fever
- headache, conjunctivitis
- rhinorrhea, sore throat, cough, lymphadenopathy
- symptoms often resolve when rash appears
- enanthem: petechial lesions on soft palate and uvula (Forchheimer’s sign)
- exanthem: itchy, pink to red macules and papules (start face, spread to body over 24 hr)
What is the treatment for rubella?
- antipyretics
- fluids
- rest
What are the preventative measures for rubella?
- vaccinations
- avoid others for 7 days after onset of rash
How is erythema infectiosum spread?
spread through contact with respiratory tract secretions, blood, vertical transmission from mother to fetus
What is the treatment for erythema infectiosum?
- acetaminophen 15 mg/kg PO q6h PRN for arthralgias (pain/discomfort)
- ibuprofen 10 mg/kg PO q8h PRN for arthralgias (pain/discomfort)
What are the preventative measures for erythema infectiosum?
avoid sun exposure, hot temperatures, stress
What is the mode of transmission of roseola infantum (exanthema subitum)?
- unknown mode of transmission
- usually benign and self-limiting
What are the signs and symptoms of roseola infantum (exanthema subitum)?
- high fever x 3-5 days that stops suddenly
- cervical lymphadenopathy
- mild URTI
- appears well
- exanthem: pink macules and papules surrounded by white halos – begins on trunk,
