Disease with Rashes Flashcards by Sarah McCaffrey

Type of rash associated with Kawasaki / Typical location

Polymorphous / Trunk

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Name the 5 symptoms associated with Kawasaki.

1) Bilateral, non-exudative conjunctivitis, 2) Mucous membrane changes (strawberry tongue, swollen lips), 3) Extremity changes (edema, desquamation, beau lines), 4) Polymorphous Rash, 5) Cervical lymphadenopathy

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What causes Kawasaki?

Linked to genetics, environment, bacteria, various viruses (coronavirus, yersinia, bocavirus)…

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Treatment for Kawasaki?

Self-limiting or IVIG and aspirin.

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Kawasaki. Rash - before/after/same as symptoms?

Same

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Rubella, aka, aka

German Measles, Milder Measles

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What virus causes rubella?

Togavirus

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Rubella - type of rash / location / duration

Fine, faint, pink maculopapular rash / face, trunk, extremities / ~ 3 days

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Associated symptoms with Rubella.

Arthralgia, post auricular and post cervical lymphadenoapathy

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Major concern with Rubella

Pregnant women contracting the disease; can cause birth defects - glaucoma, cataracts, hearing deficits, heart defects

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Rubella Treatment

Self-limiting in adults - acetaminophen, IVIG in pregnant women

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Population(s) Rubella affects?

Both kids and adults

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Etiology of Rickettsia

Rickettsia, aka “Rocky Mountain Spotted Fever” is caused by tick bites

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Most common time of year / place to contract Rickettsia:

April - September / the south

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Progression of TYPE of rash associated with Rickettsia:

Macular rash –> maculopapular –> petechiae

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Progression of LOCATION of rash associated with Rickettsia:

wrists/ankles –> rest of body (palms/soles not spared)

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Other associated symptoms with Rickettsia:

fever, HA, chills, N/V, hard palate lesions, facial flushing, conjunctivitis

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With Rickettsia, which starts first - rash or fever?

Fever starts abruptly and rash starts 2-6 days later

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Treatment for Rickettsia

Doxycycline

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What causes Roseola Infantum? / What else is it called?

HHV-6 or 7 / 6th Disease

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Who tends to get Roseola?

Kids ages 0-3

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What type of rash is associated with Roseola?

Rose pink maculopapular rash

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What is the progression of Roseola Infantum?

Abrupt onset of a high fever (40.6 C) that lasts 8 days; fever ends abruptly; then the rash appears

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Treatment for Roseola Infantum?

Antiviral that is NOT acyclovir & acetaminophen - control fever!

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Who tends to get Erythema Infectiosum?

Children 5-15

What else is Erythema Infectiosum called?

5th disease

What causes Erythema Infectiosum?

Erythrovirus (parvovirus)

Characteristic rash of Erythema Infectiosum?

Slapped cheek rash --> lacy, reticular maculopapular rash on trunk and limbs

Treatment for Erythema Infectiosum?

IVIG

In Erythema Infectiosum, does the rash come on before/after/same time as fever?

Same time

How do you get Lyme disease? / Region?

Ticks / NE & N central

What type of rash is characteristic of lyme disease?

Erythema migrans

What does Erythema Migrans mean?

Raised red, target-like lesion with central clearing

Do you get the rash or fever first in lyme disease?

Rash (lesion)

Stages of Lyme disease:

1) flu symptoms w/erythema migrans rash, 2) weeks-months later - facial, CN 7 palsy, 3) months - years: arthritis

Treatment for Lyme disease:

Doxy

What organism causes lyme disease?

B. burgdorferi, spirochete

What organism causes Toxic Shock Syndrome?

Staph aureus

What is the rash associated with Toxic Shock Syndrome look like?

Diffuse macular erythematous rash w/ peeling skin

Does the rash or fever come first in Toxic Shock Syndrome?

Fever comes first, then rash.

What can you NOT use to diagnose Toxic Shock Syndrome?

Blood cultures will be negative b/c infection is due to toxin NOT systemic infection.

Treatment for Toxic Shock Syndrome?

Antibiotics, rapid rehydration

What is another term for Rubeola?

Measles

What is the prodrome for Rubeola?

3 Cs! & high fever, malaise, yellow exudate on throat

What are the 3 Cs?

Cough, Coryza (runny eyes), Conjunctivitis

What other skin finding is characteristic of Rubeola?

Koplik spots

What are Koplic spots?

Little white spots around the 2nd molar

What type of rash is characteristic of Rubeola?

Brick red, irregular, maculopapular rash; rash is uniformly erythematous in some areas

Spread of rash?

Begins on face and proceeds down and out

What organism causes measles?

Paramyxovirus

Treatment for Rubeola?

Isolation, treat fever

In Rubeloa, does the rash appear before or after fever?

After fever

Varicella Zoster causes?

Chicken pox and shingles

Characteristic rash of Varicella Zoster?

Dew drops on rose petals

Rash progression of Varicella Zoster?

blisters --> crusting

Dx of Varicella Zoster

Multinucleated giant cells on Tzank Smear

In Varicella Zoster, does rash or fever come first?

Fever comes first or they present at same time.

What are the two types of Typhus?

Endemic and Epidemic

Endemic Typhus is caused by (organism) / transmitted by?

Rickettsia typhi / fleas on rats

Epidemic Typhus is caused by (organism) / transmitted by?

Rickettsia prowazekii / Lice

What living conditions would Typhus arise from?

Crowded, unsanitary, think famine/war

Which type of Typhus (endemic or epidemic) is more severe?

Epidemic is more severe

Type of rash characteristic of Typhus?

Maculopapular

Prodrome associated with Typhus?

Abrupt onset of fever, HA, cough, arthralgia, chills, severe HA

Typhus rash tends to spare:

face, palms, soles

Does the rash or fever come first with Typhus?

Fever comes first.

Scarlet Fever is a complication of?

Group A Streptococcus

What time of year is Scarlet Fever most common?

Winter/early spring

Does rash present after or before fever in Scarlet Fever?

Rash presents after 1-2 days of illness

Prodrome of Scarlet Fever?

Exudative sore throat, HA, fever, abd pain

Describe the rash in Scarlet Fever

Rash is rough like fine-grade sand paper; erythema blanches w/pressure; may itch, no pain; petechiae might be present; can resemble sun burn

What does Scarlet Fever spare?

palms and soles

2 other symptoms associated with Scarlet Fever (related to skin)

Paleness around mouth, strawberry tongue

Treatment for Scarlet Fever?

Penicillin VK

Rash starts before fever in which disease(s)?

Lyme Disease

Rash starts after fever in which diseases?

Rocky Mountain Spotted Fever (2-6 days), Roseola (after fever breaks), Toxic Shock, Rubeola, Rubella, Typhus, Scarlet Fever