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Med school Child Health > Rashes > Flashcards

Rashes Flashcards

1
Q

History

A

Duration, site of onset, evolution and spread
Does it come and go (eg urticarial)
Itch (eczema, scabies)
Recent drug ingestion/exposure to provocative agents (sunlight, food, allergens, detergens)
Other contacts affrected (viral exanthems, infestations)
Other symptoms (sore throat, URTI)
FH (atopy, psoriasis)

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2
Q

Examination

A

Check for non-derm features: fever; mucous membranes; lymphadenopathy; splenomegaly; arthropathy
Describe rash in derm language - morphology (size, shape, colour, macules, papules, nodules, vesicles, pustules, bullae, petechiae, purpura, ecchymoses); arrangement and distribution (flexors, extensors, mucus membranes - measles, Kawasaki)
Palpate - scale thickness, texture, temp, dry skin

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3
Q

Causes: scalp

A

Seborrheic dermatitis
Eczema
Psoriasis
Fungal

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4
Q

Causes: mucous membranes

A

Measles
Kawasaki disease
Stevens-Johnson syndrome
Herpes

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5
Q

Causes: trunk

A

Viral exanthems

Molluscum contagiousum

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6
Q

Causes: flexor surfaces

A

Eczema

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7
Q

Causes: extensor surfaces

A

Psoriasis

HSP

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8
Q

Causes: web spaces

A

Scabies

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9
Q

Causes: nails

A

Fungal infections

Psoriasis

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10
Q

Causes: shin

A

Erythema nodosum

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11
Q

Maculopapular rash

A

Generalised

Most likely viral exantham, might be drug induced eruption

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12
Q

*Measles

A

Maculopapular rash
Prodrome of fever, corysa and cough
Koplik’s spots in mouth just before rash appears
Rash tends to coalesce

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13
Q

*Rubella

A

Maculopapular rash
Discrete, pink macular rash
Starts on scalp and face
Occipital and cervical lymphadenopathy may precede rash

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14
Q

*Roseola infantum

A

Maculopapular rash
<3years
3 days of sustained fever followed by pink morbilliform eruption appears as temp subsides
HHV-6 or HHV-7

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15
Q

*Enteroviral infections

A

Maculopapular rash
Generalised, pleomorphic rash
Mild fever

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16
Q

*Glandular fever

A

Maculopapular rash
Malaise, fever, exudative tonsillitis
Lymphadenopthy and splenomegaly commonly found

17
Q

*Kawasaki disease

A 
Maculopapular rash
Protracted fever
Generalised rash
Lymphadenopathy
Conjunctival inflammation
18
Q

*Scarlet fever

A

Maculopapular rash
Fever and sore throat
Rash starts on face
Strawberry tongue

19
Q

Chickenpox

A 
Vesicular rash
Papulovesicles on erythematous base
Vesicals become encrusted
Lesions at different stages
Involvement of mucous membranes
20
Q

Eczema herpeticum

A

Vesicular rash

Exacerbation of eczema with vesicular spots caused by a herpes infection

21
Q

Haemorrhagic rash

A 
Due to extravasated blood
Do not blanche
Classified on size
Petechiae - smallest
Purpura - middle
Ecchymoses - biggest
22
Q

*Meningococcal septicaemia

A

Haemorrhagic rash

Petechial or purpuric, may be preceded by maculopapular

23
Q

Acute leukaemia

A

Haemorrhagic rash
Pallor
Hepatosplenomegaly

24
Q

*Idiopathic thrombocytopenic purpura

A

Haemorrhagic rash
Child looks well
Petechial rash
+/- nosebleeds

25
Q

*Henoch-Schoenlein purpura

A

Haemorrhagic rash
Legs and buttocks
Arthragia
Abdominal pain

26
Q

Bleeding disorders

A

Haemorrhagic rash
Heamophilia, von Willebrands disease and Ehlers-Danlos usually present with easy bruising and prolonged bleeding following trivial trauma
nb. non accidental injury

27
Q

Urticarial rash

A 
Hives
Transient, occurs rapidly and fades
Itchy
Raised weals
Food, drug, contact allergy; infections
28
Q

Erythema multiform

A

Distinctive, symmetrical rash
Annular ‘target’ lesions and various other lesions including macules, papules and bullae
Severe form with mucus membrane involvement is Stevens-Johnson syndrome
Causes include infections (HSV, EBV, mycoplasma) and drugs. Most commonly idiopathic and self-limiting

29
Q

Erythema nodosum

A

Red, tender, nodular lesions
On shins
Important causes are strep infections and TB

30
Q

*Impetigo

A

Highly infectious
Commonly occurs on face, especially if pre-existing skin condition (eczema)
Erythematous macules develop into characteristic honey-coloured lesions
Topical antibiotics (eg mupirocin) if mild
Systemic abx (eg fluclox) if more severe
Nasal carriage important source of reinfection - eradicated by nasal cream containing clorhexadine and neomycin

Med school Child Health (57 decks)

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