INFLAMMATORY RASH

Question 1

Approach to Kawasaki’s

Answer 1

Vasculitis

Fever for >/ 5 days without a source

AND

4/5 Criteria:
a. Conjunctivitis
b. Rash - various
c. Lymphadenopathy
d. Oropharyngeal Changes (injection of the pharynx, cracked lips, prominent papillae of tongue
e. Extremity erythema and edema with later desquamation of fingers and toes

Complications: coronary artery aneurysms

Management:
IV immunoglobulin
Aspirin

Question 2

Approach to Henoch-Schonlein Purpura

Answer 2

Most common vasculitis in childhood

Palpable purpura on buttocks, thighs, legs, arms

GI symptoms: vomit, diarrhea, abdominal pain

Polyarthralgias

Hematuria and proteinuria

Get a urinalysis (and renal function tests in presence of hematuria)

Consider prednisone 1 mg / kg / dose for 2 weeks followed by a 2 week taper for severe joint and GI symptoms

Ibuprofen 10 mg / kg / dose PO q 6 hrs for arthralgia and extremity edema