Erythematous Rashes Flashcards
Generalized erythema
Erythematous macules/papules that are widesrpread and often become confluent
Drug eruptions…what to look for, type of txn, appearance nad location
Sudden onset of a symmetric morbilliform rash
Antibiotics, NSAIDS, furosemide, hydrochlorothaizide
Most common cutaneous drug reaction
Not a true allergy, but a delayed type hypersensitivity rsxn from drug specific T cells
Usually sudden appearance with instense red macules on the trunk…over next seveeal days may coalesece and spread to extrimities
Diagnosis of drug eruption
Diagnosis in individuals who develop red eruption across trunk with areas of confluence 1-2 after starting a new med…stop the offending drug
DRESS…type of rxns, drugs, timeline
Drug reaction wit heosinophilia and systemic sympomts
Delayed- type hypersnesitivity rxns
Anti-epileptics, sulfonomaides, allopurinol
2-6 weeks after drug initiaion
Morbilliform pattern with systemic sx…may also get hematologic abnormalities
Organ dysfunction of DRESS and amagement
Liver- hepatomegaly, elevated ALT or bilirubin
Kidney - acute intersitital nephritits
Lung - tachypnea, dyspnea, hypoxemia
Discontinue
SJS and TEN…pathology, timeline, sx
Stevens-johnson and toxic epidermal necrolysis
Drug eruptions…cell-mediated reactions leads to massive keratinocyte apoptosis of cutanoues and mucosal epidermis
2-6 weeks and same drugs as DRESS
Influenza-like illness
Skin will be tender to touch and can blister
SJS and TEN differences, managment
SJS is less than 10% blistering…TEN is more than 30…overlap in between
Discontinue but may take 2-4 weeks for full healing
Viral exanthem
One of the most common childhood diseases`
Morbillivius dz and characteristics
Rubivirus dz and characteristics
Measles - fever, cough, coryza and conjunctivities (3 Cs)
Rubella - self-limited of low grade fever and mild rash for 1-3 days
Parvovirus and HHV 6 dz and characteristics
Erythema infectiosum (Fifth-s dz) - edematous, erythematous plaques on cheeks (slapped cheeks) and red macuklar/reticular rash on trunk and extremities (lace-LIke)
Roseola infantum (exanthem subitum) - prodrome of fever, irritability, and malaise about 4 days…once fever usbsides, macules nad papules form
Enterovirus and EBV dz and cahracteristics
Vrious…some can be vesicular
MONO - fever, malaise, tonsillitis, pharyngitics…rash after B-lactams
Viral exanthem patho
Gain entery through resp (most) or GI (enterO), a viremic phase allows dissemination to the skin…most present with prodrome of fever and const sx
Measles ….org, transmission, course, complications
Infection with morbillivirus rubeola
Highly contagious with airborne transmission
2-4 days prodrome of fever, malaise, and anorexia followed by cough, coryza and conjuntivities…get Koplik’s spots on buccal mucosa
Then get rash on face that spreads to trunk and extrimities…recovery occurs after appearance of the rash
Can get pulm and neuro infection
Penumoniia most common cause of death
Encephalitis, subactue scleorsing panencepahitlis
Measles dx
Unimmunized with maculopapular rahs for over 3 days with fever and 3 Cs…can test for measles IgM
Rubella…course, time, complications
Mild ilness with fever, cough, ad ncoryza followed by macules and papules on face, trunk and extremities for 1-3 days
Adults can get post-viral arthritis
Infection during pregnancy can get ocngnenital rubella syndrome
Erythema infectiosum…org, transmission, course, hallmark, comps
Parvovirus B19
Enters through resp and replicate in erythroid progenitor cells in bone marrow
Mild febrile with prodrome of fever, coryza, HA, N and diarrhea
Slapped cheecks with lacy rash
Most recover over next week but some with arthritis
If hands, wrists, knees, feet hurt, then intial manifestations of rheumatoid arthritis
If chronic hemolysis then can get aplastic chrisis…pallor and lethargy with anemia
Roseola infantum…org, age, sx, course, comp
HHV6…under 2 y/o
High fever, conjunctivitis, and pharyngitis for 3-5 days…as fever resolves, get rash…rash self limitied
Seizures are comp
Enterovirus infection…course and sx
Wide variety…most have mild febrile illness…normally prodrome of 1-2 days followed by development of macules and papuleson trunk and moving to extremitieis
Mono…org, what to look for
EBV
Prodrome of fever, HA, low grade fever with tonsillits, pharyngitis and cervical lymph node nelargemnt
Rash is uncommon…100% will develop a rash after Beta-lactams due to misdiagnosis of strep
Scarlet fever…patho, course, sx,
S. pyogenes with production of erythrogenic exotoxin
Results in pharyngitis and erythematous exanthema
Diffuse plaques that feel like “sandpaper”
Starts in flexurla and moves to trunk and extrmeities
Pastia’s sign - accented in flexural
