Rashes of childhood

Question 1

What conditions might give a maculopapular rash?

Answer 1

macules - flat change in colour (often red) <0.5cm
papules - raised often red <0.5cm

measles
rubella (only macules)
HHV6 / HHV7
enterovirus
scarlet fever
Kawasaki's disease
DRUGS

Question 2

What conditions might give a purpuric / petechial rash?

Answer 2

non blanching red/purple coloured spots. Test with a glass.

meningococcal
Henoch-Shonlein purupura
enterovirus
thrombocytopenia

Question 3

What conditions might give a vesicular rash?

Answer 3

raised, dome shaped lesion, <5mm, contain colourless fluid

chicken pox
shingles
herpes simplex
hand foot and mouth

Question 4

What conditions might give a pustular / bullous rash?

Answer 4

raised dome shaped lesions .5mm, colourless or with pus

impetigo
scalded skin syndrome

Question 5

What conditions might give a desquamating rash?

Answer 5

epidermal layer peels away, most often on exremities.

after scarlet fever
Kawasaki’s disease
after measles

Question 6

What is a Mongolian blue spot?

Answer 6

May be seen on neonate: congenital patch of blue, fades as child ages, typically on lower back

Question 7

What is erythema toxicum?

Answer 7

Seen in new borns 2-5day, unknown cause

blotchy red patches on skin, sometimes with papules and pustules

normally resolves without treatment

Question 8

What is a strawberry naves?

Answer 8

aka strawberry haemangioma

usually seen on newborns at 6-7 weeks, not present at birth.

raised lumpy spot, well demarcated, can grow for 18months, will disappear by 7 yrs old (can occur in trachea)

no treatment unless near eye or trachea in which case surgery but bleed a lot, can reduce size with beta blocker and steroids first.