Pediatric Exanthems and Spinal Dysgraphism -Pham

Question 1

What are the signs of Spinal Dysraphism? What should you do?

Answer 1

o	Limb weakness or paralysis
o	Loss of sensation
o	Urinary or fecal incontinence or retention
o	Asymmetrical limb length
o	Abnormal gait
o	Pain
o	Scoliosis

→ refer to a neurologist for an MRI of the spine*

Question 2

When is Measles contagious?

Answer 2

From 1-2 days before the onset of symptoms to 4 days after the rash appears

Question 3

What sign, if found, is pathognomonic for measles?

Answer 3

Koplik spots

Appear first on buccal mucosa nearest the 2nd lower molars as 1 mm grey-white papules on red base

Question 4

Where dos the macular-papular rash of measles begin and spread?

Answer 4

• Macular-papular/ morbilliform lesions begin on the anterior scalp hairline and behind ears
• Rash quickly spreads to the face
• day 2-3–> trunk and extremities
• day 3: whole body

Question 5

How long after the onset of a measles rash should a pt remain isolated?

Answer 5

4 days after the onset of the rash

Question 6

What bacteria is responsible for Scarlet Fever?

Answer 6

Group A beta hemolytic Streptococcal pharyngitis and exanthem

Question 7

What does the rash associated with Scarlet Fever look like?

Answer 7

• Begins on neck then spreads to trunk and extremities
• Spares the palms and soles
• **“Sandpapery”, coarse texture
• Pastia lines/sign: rash becomes more intense around the skin folds and forms lines of confluent petechiae (or confluent area without lines=sign)

Question 8

What does the rash of Rubella look like? What other symptoms are associated with a Rubella infection?

Answer 8

• Lesions are pale pink, morbilliform macules, smaller than measles
• Rash covers entire body within 24 hours and resolves by the third day
• Forscheimer’s Spots – erythematous and petechial macules on the palate and uvula (in early infection)

-LAD, Arthralgias and arthritis

Question 9

What is Erythema Infectiosum (Fifth Disease) associated with?

Answer 9

Parvovirus B19

Question 10

What does the rash of Erythema Infectiosum look like?

Answer 10

• “slapped cheek” appearance 2-3 days after prodrome

- 1-4 days later: Reticulate & lacy pattern on proximal extremities and later the trunk

Question 11

What is Roseola Infantum associated with? How does it present?

Answer 11

• HHV6 and 7
• high fever in prodromal stage
• On 4th day, fever drops and morbilliform exanthem begins on the trunk and spreads to the face/extremities

Question 12

What is Hand, Foot and Mouth Disease associated with? how is it transmitted? What does the rash begin with and look like?

Answer 12

• Coxsackievirus A viruses (16 most common)
• Fecal-oral
• Rash begins with painful vesicles and erosions in the mouth then papulovesicles on the palms, soles, sides of hands and feet and butt
• self-limiting