Exanthamatous Disease Flashcards by Zahra Kalifa

What should be examined in cutanous disordersr

Skin, hair, nails, mucus membranes

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Name examples of maculopapular rash

1- Measles 
2- Rubella 
3- Scarlet fever
4- SSS 
5- CMV
6- Erythema infectiousum 
7- Roseola infantum 
8- Kawasaki

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Name examples of Papulovesicular rash

1- vericella zooster
2- enterovirus and coxakie
3- imptigo

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How does child with herpes simplex usually present?

With painful perioral vesicles

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What is the incubation period of measles?

9-11 days

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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

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How does measles rash progress clinically

Face and neck > trunk > extremities

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How does the distribution of measles rash look like

Face\trunk: confluent

- extremities: discrete

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What is the pathognomic sign of measles?

Koplik spot

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What are the complications of measles

bronchopneumonia

- suppurative otitis media

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What is the management of measles?

immunocompetent: Vitamin A

- immunocompromised: Ribavirin - Immunoglobulin

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How to prevent measles

live attenuated measles vaccine

- MMR

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Differentiate between rubella and measles incubation period:

Measles: <2wks (9-11d)
Rubella: >2wks (13-21d)

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How is rubella usually transmitted?

As an airborne infection

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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]

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Differentiate desquamation in measles and rubella

Rubella does not desquamate, measles only in the extremeties

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Name symptoms that may present in rubella:

Along with the rash we may have

lymphadenopathy
malaise
coryza
conjunctivitis
small joint pain

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What are the complications of rubella?

Thrombocytopenia - encephalitis

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What is the management of rubella

Supportive + NSAIDs for joint pain

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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?

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