Exanthamatous Disease Flashcards
What should be examined in cutanous disordersr
Skin, hair, nails, mucus membranes
Name examples of maculopapular rash
1- Measles 2- Rubella 3- Scarlet fever 4- SSS 5- CMV 6- Erythema infectiousum 7- Roseola infantum 8- Kawasaki
Name examples of Papulovesicular rash
1- vericella zooster
2- enterovirus and coxakie
3- imptigo
How does child with herpes simplex usually present?
With painful perioral vesicles
What is the incubation period of measles?
9-11 days
How does measles develop clinically (course)
1- 3 to 4 days of fever, conjunctivitis, and coryza > kpolik spot >
2- rash appears on the third day\ recovers in 5th\6th day
How does measles rash progress clinically
Face and neck > trunk > extremities
How does the distribution of measles rash look like
- Face\trunk: confluent
- extremities: discrete
What is the pathognomic sign of measles?
Koplik spot
What are the complications of measles
- bronchopneumonia
- suppurative otitis media
What is the management of measles?
- immunocompetent: Vitamin A
- immunocompromised: Ribavirin - Immunoglobulin
How to prevent measles
- live attenuated measles vaccine
- MMR
Differentiate between rubella and measles incubation period:
Measles: <2wks (9-11d)
Rubella: >2wks (13-21d)
How is rubella usually transmitted?
As an airborne infection
Differentiate between the (fever & rash) in rubella vs measles:
[5 differences]
- rubella: [no prodermal - same distribution - faster rate - pink - discrete]
- measles: [prodermal - same distribution - slow “3days” - brown - confluent + discrete]
Differentiate desquamation in measles and rubella
Rubella does not desquamate, measles only in the extremeties
Name symptoms that may present in rubella:
Along with the rash we may have
- lymphadenopathy
- malaise
- coryza
- conjunctivitis
- small joint pain
What are the complications of rubella?
Thrombocytopenia - encephalitis
What is the management of rubella
Supportive + NSAIDs for joint pain
What is the organism responsible for scarlet fever?
Group A hemolytic strep
What is the incubation period for scarlet fever?
2-5 days
How do patients with scarlet fever usually present?
With fever and sore throat occuring in the same day
Differentiate between rubella duration of rash and scarlet fever duration of rash?
- rubella: 3 days only
- scarlet: 5 days
How is the distribution of rash in scarlet fever?
Face & neck > trunk & extremities
[spars soles and palms]
Oral examination of scarlet fever will show:
- red papilla
- white coat on tongue
- circumoral pallor
What is the characterstic feature of rash in scarlet fever?
It’s sandy
It’s desquamating in 4 weeks
Strawberry tongue can be found in which diseases?
- kawasaki
- scarlet fever
Culture from nasopharynx of scarlet fever will show
Antistreptolysin O titer
How to treat scarlet fever
Antibiotics (penicillin - ampicillin)
Staphylococcal infections are
- scalded skin syndrome
- toxic shock syndrome
Differentiate between. ‘’Sss and toxic shockd syndrome rash”
- sss: bullae appear in 1-2d, epidermis seperate into large sheets and show moist. Red shiny surface beneath
- toxic shock syndrome: scalatinoform in trunk and extremities + edema + desquamation
How to treat SSS?
Penicillin - if resistant give clindamycin, coxacillin, 1st gen cephalosporin-
What is the sign seen in SSS?
Nikolsky sign
May present with impetigo or puruelent conjunctivitis
What is the organism that causes erythema infectiousum?
Parvovirus B19
Which group of population are we more concerned about with erythema infectiousum
- pregnancy (hydrofetalis + hemolytic disease)
- sickle cell disease (aplastic crisis)
What is the disterbution of rash in erythema infectiousum?
- Cheeks (slapped cheeks appearance)
- maculopapular rash over upper and lower extremeties
What does erythema infectiousum cause to the general population?
Polyarthropathy
Whats the organism that causes roseola infantum?
human herpes virus 6 (HHV-6)
What is the course of rash and fever in roseola infantum?
The fever will occur first, then subsides then rash occurs
“Opposite of measles”
The appearance of roseola infantum resembles which dermatological condition?
Rubella and measles
What are the special characterstics of varicella?
1- rapid from macule > papule > vesicle> crust
2- central disterbution
3- all stages can occur in any antomical site.
4- present in scalp + mucus membrane
5- crusting of all lesion
Is there a prodermal duration for vericella?
No
What is the most common complications of vericella
Vericella pneumonitis
What is neonatal vericella
- mother w\chicken pox, deliver a baby
- associated w\multisystem disease
- give the child immunoglobulins & keep him beside his mother to avoid infection
What other complications might be associated with vericella?
Hepatitis, retinal\cerebral disease, thrombocytopenia, bacterial skin infection.
When to treat vericella and how to treat it?
When patient is immunocompromised - with acyclovir.
General public: antihistamine to reduce itching
Differentiate between the rash in eczema herpeticum and herpes zooster
- herpeticum: profused vesicular\pustular rash on eczema site.
- zoster: grouped vesicles confluent along the line of affected nerve
What is the bacterial infection in impetigo?
Gram positive bacteria
“GABHS” + Staph aureus
What age is impetigo more common in
Below 6 years
