Rash Flashcards

1
Q

Differentials of Rash

A
  1. Herpes zoster*
  2. Urticaria*
  3. ITP*
  4. Allergic - contact or atopic dermatitis
  5. Varicella
  6. Measles
  7. Rubella
  8. Impetigo
  9. Cancer - Leukemia, lymphoma
  10. Scabies
  11. Psoriasis
  12. HSP
  13. Meningococcemia
  14. HIV
  15. EBV
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2
Q

Rash - Key points in history

A
  • Should be adapted to patient’s age as viral exanthema common in children.
  • Site and mode of onset of rash, mode of progression and past history (e.g. eczema).
  • Constitutional disturbance (e.g. pyrexia, pruritus).
  • Drug history and exposure to irritants.
  • Diet including unaccustomed food.
  • Herald patch (pityriasis rosea).
  • Contact with infectious diseases including child carecentres and school.
  • Overseas travel.
  • Bleeding or bruising tendency.
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3
Q

Rash - Key points in PE

A

Skin of whole body
•Nature and distribution of the rash including lesion characteristics
•Nails and soles of feet
•Scalp, mucous membranes and oropharynx
•Conjunctivae and the lymphopoietic system (?lymphadenopathy, ?splenomegaly)

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4
Q

Rash - Key investigations

A
Many diagnoses are clinical. 
Consider:
•FBE/ESR/CRP
•EBV test
•HIV test
•serology for rubella, parvovirus, syphilis and other suspected infections
•viral and bacterial cultures.
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5
Q

Rash - Diagnostic tip

A
Be vigilant for the deadly meningococcal septicaemia, which may present as an erythematous rash initially prior to the development of purpura.
•Prescribed drugs are a common cause of rash, especially toxic erythema. 
Examples are 
1. antibiotics, especially penicillin, 
2. thiazides, 
3. anti-epileptics, 
4. allopurinol, 
5. NSAIDs and other 
6. anti-arthritic agents
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