Viral Exanthems Flashcards
Erythema multiforme with brief prodrome, widespread cutaneous and mucous membrane involvement.
Stephen Johnsons Syndrome
What viral rash is preceded by pain along the dermatome?
Herpes Zoster, Varicella-Zoster, VZV, shingles
Doesn’t cross the midline and only affects one dermatome.
T/F the Herpes Zoster rash is preceded by a prodrome.
True
Eruption is often preceded by a prodrome of pain, dysesthesia or pruritis in the affected dermatome.
Described as itching, aching, burning
What is the treatment for Herpes Zoster and VZV?
- Oral acyclovir - works best if started within 72 hrs of rash onset. Will still benefit if given later.
- Ibuprophen, gabapentin for nerve pain/discomfort
- Fever management
- Cool, moist compresses, calamine lotion, aluminum sulfate (Domeboro) soaks.
What diagnostic test can used to determine HZ?
Tzanck test.
Does not distinguish between VZV and HSV.
When is HZ no longer contagious?
When the vesicles crust over.
When is the varicella vaccine administered?
1st at 12 mo
2nd age 4-5
Which conditions presents with fever, abdominal pain, headache, vesicular rash w/ pinpoint lesions that begin on the face and spread to the trunk?
Varicella Zoster
When is oral antiviral therapy used for VZV/HZ?
Immunocompromised, other comorbidities and older kids.
What are some complications of VZV/HZ?
Bacterial infections, necrotizing fasciitis, osteomyelitis, septic arthritis and Guillian Barre syndrome.
Which condition presents with a prodrome of high fever, coryza (runny nose), cough and Koplik spots?
Measles
Which rash is a maculopapular blanching rash that initially presents in the hairline, forehead and behind the ears before spreading cephalocaudally?
Measles
Disappears in the order it appeared. It peels as it resolves (desquamic)
Which condition presents as arthritis in adults?
Erythema infectiosum (fifth disease)
This rash appears 7-10 days after prodrome. It’s bright red erythema appears abruptly over the cheeks (slap face), an erythematous morbilliform rash presents on the extremities and fades in a reticulate lacy pattern.
Erythema infectiosum (fifth disease)
Slap cheek appears absent in adults.
Lacy appearance can come and go when exercising or when exposed to sun.
Which condition has a prodrome that presents with headache, malaise, pharyngitis and itching?
Pityriasis rosea
Which rash initially presents with a herald patch followed by more eruptions one week later that morphs into a Christmas tree appearance?
Pityriasis rosea
What condition is primarily seen in infants? It starts with high fever followed by abrupt onset of rash from the trunk to extremities (spares the face). May have febrile seizures and periorbital edema.
Roseola
Rose pink maculopapular rash
Roseola
Which prodrome presents primarily in adults with malaise, low-grade fever, coryza, mild conjunctivitis and URI sx, sub occipital and post auricular glands lymphadenopathy and Forschheimer spots?
Rubella (German Measles)
Pink macules and papules on the face that spread to the trunk and extremities. Fades in the same order it appears.
Rubella (German Measles)
Tear-drop vesicles, dew drop on a rose petal rash. Can present in multiple stages at the same time.
VZV Chickenpox
Presents with mild low-grade fever, sore throat, malaise with submandibular and cervical lymphadenopathy. Oral lesions are the presenting sign followed by cutaneous lesions appearing within 24 hours.
Hand-foot-mouth disease
Red macules turns pale, white oval vesicles with a red areola appear on the palms, soles, dorsal aspects of the fingers and toes and occasionally on the face, buttocks and legs.
Hand-foot-mouth disease
Transmitted by fecal-oral route. Possibly respiratory
Hand-foot-mouth disease
