Infectious Rashes Flashcards
A 10 year old complains of this itchy and flaky scalp rash that has become squishy. He is afebrile, and has no other lesions. How should this be managed?
Kerion. Severe tinea capitis. Tx is oral griseofulvin 15-20 mg/kg/day divided BID for 6-8 weeks with a whole glass of milk and selenium based shampoo BID as an adjunt. Topical natifungals are insufficient bc they d/n penetrate the follicle. D/N I+D.
A 10 year old has these painful lesions on her shins. What is the lesion? How should you treat it?
Erythema nodosum (EN). Self limited painful nodules originating in the hypdermal fat layer. Lesions last up to 2 weeks but new lesions can develop up to 6 weeks from the onset. Usually associated w/ underlying condition ie infection (strep, fungus, tb), rheum, medications, malignancy. Tx w/ supportive care, NSAIDs. (Steroids, abx, ivig can help underlying dz but not the lesions).
14 yof was sitting in an under chlorinated hot tob and found to have this rash.
Pseudomonal Hot Tub Folliculitis
Tends to be associated with water slides, hot tubes, under chlorinated warm water environments. Very itchy or painful. Usually self resolving. Occassionaly requires antibiotics.
18 month with hx of sig atopic dermatitis presents with this this vesicular hemmorrhagic lesion on the face.
Eczema Herpeticum
A 15 year old developed a oval plaque on her abdomen and then over the course of the next two weeks, many smaller plaques and papules.
Pityriasis rosea:
Common skin rash. Herald rash followed by daughter patches and plaques. Can feel scaly. Spares the palms, feet, soles, and usually the face. Maybe pruritic. Lasts for 6-8 weeks. Can try topical steroids. Usually adolescents. Unclear etiology, perhaps 2/2 to virus. Not contagious.
3 year old with a painful lesion on the hand.
Herpetic Whitlow
Autoinnoculation onto skin of HSV.
8 month old with high fever and then 2 days later.
Roseola
Caused by HHV-6. Occurs 3-5d after fever. Associated with febrile seizure. Usually systemic. Typically younger children.
12 year old adopted male presents with fever, and non purulent conjunctivitis. Oral exam reveals these blueish-white spots and there is a maculopapular rash.
Measles
Vaccination is highly effective in prevention.
Prodrome of cough, conjunctivitis (nonpurulent), coryza.
Oral exam: Koplik spots (Blueish-white spots).
Complications include aseptic meningitis, pneumonia, subacute sclerosing panencephalitis
6 yom with complement deficiency presents with high fever, ill appearance, and this rash.
Purpura Fulminans.
Caused by Niserreia Meningitides. Can be rapidly fatal despite antibiotics, may lead to adrenal dysfunction. Associated with people who have complement deficiency.
3 year old with cough, diarrhea, and the associated distinct, firm, red raised spots.
Gianotti-Crosti Syndrome
Associated with EBV, coxscackie, first described with Hep-B. Viral exanthem associated with distinct, firm, lichenified papules associated with virus. Clears within 2-3 weeks.
3 year old adopted male with recent travel to village in Africa with this skin finding.
Chiken Pox (Varicella Virus)
Dew drops on a rose petal, vesicles at varied stages of evolution. Can use acylovir or valacylovir on immunocomprimised hosts.
14 yom from Guilford, went camping, discovered this lesion.
Early Lyme Disease: Erythema Migrans
Appears in approximately two-thirds of symptomatic of cases, usually 7 to 14 days after the tick bite.
3 year old with cold sores.
Herpes gingivostomatitis
HSV-1 90%, could be HSV-1. Treatment for children with herpetic gingivostomatitis who present within 72 to 96 hours of disease onset if they are unable to drink or have significant pain
A 7 year old develops slightly itchy bumps on his arms.
Molluscum Contagiosum
Caused by a pox virus. Sometimes with central umbilication. Other times have central protrusion. Found on trunk, face, axillae, genital area. Undergo spontaneous remission in 2-3 years.
What is this finding called, commonly seen in this rash syndrome that is associated with a red, bumpy tongue and a red sandpaper like rash.
Pastia’s lines in the setting of scarlet fever 2/2 GAS. Pastia’s lines are prominent anteciubital erythema that can be found in association.
15 year old returning from traveling to SE Asia with high fever, arthralgia, and associated rash.
Chikungunya
Associated with Aedes moquito. Associated with travel to endemic areas including SE asia, South Africa, Carribeal Islands. Treatment is supportive.
2 year old female with difficulty feeding and the associated rash.
Hand, foot, and Mouth DIsease
3 year with bright red patches on both cheeks.
Erythema Infectiousum (Parvovirus B19)
Associations: Slapped cheek facial erythema, reticulated (lacy) rash. Can be associated with diarrhea, arthrtis.
Complications: Aplastic anemia in ppl with RBC dyscrasias, hydrops, myocarditis
