Disease with Rashes Flashcards
Type of rash associated with Kawasaki / Typical location
Polymorphous / Trunk
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
What causes Kawasaki?
Linked to genetics, environment, bacteria, various viruses (coronavirus, yersinia, bocavirus)…
Treatment for Kawasaki?
Self-limiting or IVIG and aspirin.
Kawasaki. Rash - before/after/same as symptoms?
Same
Rubella, aka, aka
German Measles, Milder Measles
What virus causes rubella?
Togavirus
Rubella - type of rash / location / duration
Fine, faint, pink maculopapular rash / face, trunk, extremities / ~ 3 days
Associated symptoms with Rubella.
Arthralgia, post auricular and post cervical lymphadenoapathy
Major concern with Rubella
Pregnant women contracting the disease; can cause birth defects - glaucoma, cataracts, hearing deficits, heart defects
Rubella Treatment
Self-limiting in adults - acetaminophen, IVIG in pregnant women
Population(s) Rubella affects?
Both kids and adults
Etiology of Rickettsia
Rickettsia, aka “Rocky Mountain Spotted Fever” is caused by tick bites
Most common time of year / place to contract Rickettsia:
April - September / the south
Progression of TYPE of rash associated with Rickettsia:
Macular rash –> maculopapular –> petechiae
Progression of LOCATION of rash associated with Rickettsia:
wrists/ankles –> rest of body (palms/soles not spared)
Other associated symptoms with Rickettsia:
fever, HA, chills, N/V, hard palate lesions, facial flushing, conjunctivitis
With Rickettsia, which starts first - rash or fever?
Fever starts abruptly and rash starts 2-6 days later
Treatment for Rickettsia
Doxycycline
What causes Roseola Infantum? / What else is it called?
HHV-6 or 7 / 6th Disease
Who tends to get Roseola?
Kids ages 0-3
What type of rash is associated with Roseola?
Rose pink maculopapular rash
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
Treatment for Roseola Infantum?
Antiviral that is NOT acyclovir & acetaminophen - control fever!
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
