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Infectious Disease > Week 6: Rashes in Infectious Disease > Flashcards

Week 6: Rashes in Infectious Disease Flashcards

1
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Learning Objectives

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2
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What is a macule?

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3
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What is a papule?

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4
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Macule vs Papule

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5
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What is a nodule?

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6
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What is a Plaque?

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7
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Nodule vs plaque

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8
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What is a pustule?

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9
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What is a vesicle/Bulla?

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10
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Pustule vs vesicle/Bulla

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11
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What are hives?

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12
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What is angioedema?

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13
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Hives vs angioedema

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14
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What are scales?

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15
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What is crust?

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16
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Scales vs crust

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17
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What is an erosion?

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18
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What is an ulcer?

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19
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What is a fissure?

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20
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Erosion vs ulcer vs fissure

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21
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What is a cyst?

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22
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What is a burrow

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23
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Cyst vs burrow

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24
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What is petechiae?

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25
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What is purpura?

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26
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Petechiae vs purpura

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27
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Question

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28
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Measles clinical presentation

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  • Fever
  • The 3 C’s:
    • Cough
    • Coryza
    • Conjunctivitis
  • Koplik spots 1-2 days prior to rash
  • The rash starts on the face and spreads down
  • Rash is NOT pruritic
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29
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Complications of Measels

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Rare complications are

  • Secon dary bacterial infection
  • Encephalitis
  • Subacute sclerosing panencephalitis
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30
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Measels overview

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31
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Rubella AKA

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German Measles

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32
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Rubella clinical manifestations

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  • Nonspecific
  • Low grade fever
  • 50% asymptomatic
  • The rash starts on the face and moves down to the trunk
    • It IS pink, NOT red like Measels
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33
Q

Rubella complications

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  • Congenital Rubella (highest risk first 4 months of pregnancy)
    • hearing-loss
    • mental retardation
    • Cardiovascular defects
    • ocular defects
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34
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Rubella overview

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35
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Reseola AKA

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HHV-6 or HHV-7

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36
Q

Roseola Clinical Manifestations

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  • Upper respiratory symptoms
  • High fever for 5-7 days
  • 90% case in children <2 y/o
  • The rash starts when fever breaks
    • spreads from neck/trunk to face and extremities
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37
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Roseola complications

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  • Occasionally high fever will trigger febrile seizures
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38
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Roseola overview

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39
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Hand-foot-mouth Disease AKA

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Coxsackievirus

40
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Hand-foot-mouth Disease clinical manifestations

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  • Fever
  • Sore-throat
  • Malaise
  • Painful sores develop in the mouth (Herpangina)
  • similar lesions on the hands and feet
  • Some appear lie blisters that break and ulcerate
41
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Complications of Hand-foot-mouth Disease

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  • Fingernail/Toenail loss (Temporary)
  • Aseptic meningitis
  • Encephalitis
42
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Hand-foot-mouth Disease overview

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43
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Fifth Disease AKA

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Parvovirus B19

44
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Fifth Disease Clinical manifestations

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  • Flu-like symptoms for 3 days
  • Rash
    • “slapped-cheek” with erythematous macular or papular lesions
    • “Lacy” rash on trunk and extremities
45
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Fifth Disease complications

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  • Arthralgias
  • Aplastic crisis
  • Fetal hydrops
46
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Fifth Disease overview

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47
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Scarlet Fever Clinical manifestations

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  • Very sore-red-throat
  • High fever
  • Headache
  • NV
  • Strawberry tongue
  • Rash
    • Begins neck, underarms and groin and then spreads
    • Red rash with sandpaper feel
    • Skin may desquamate
    • Pastia’s lines
48
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Complications of Scarlet Fever

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  • Rheumatic fever
  • Poststreptococcal glomerulonephritis
49
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Scarlet Fever AKA

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Group A Strep

50
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Scarlet Fever overview

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51
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Penicillin Skin Rash

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  • Occurs hours or sometimes days after exposure to penicillin
  • Skin rash can be macular, papular or hives
  • Associated itching, swelling, possible wheezing or anaphylaxis
  • Can be diagnosed via skin testing
  • Desensitization available
52
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Question

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53
Q

Chicken Pox AKA

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Varicella or VZV

54
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Chicken pox clinical manifestations

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  • Mild fever
  • malaise 1-2 days prior to the rash
  • Rash
    • Starts on the head/chest/back and then generalizes
    • macules to papules to vesicles to crust
    • varying stages of lesions
55
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Complications of Chicken pox

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  • Secondary bacterial infections of skin
  • Pneumonia in adults
  • Rarely encephalitis or cerebellar ataxia
56
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Chicken pox overview

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57
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Shingles AKA

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Herpes Zoster

58
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Shingles Clinical manifestations

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  • Pain
  • Itching
  • Tingling of skin dermatome
  • Rarely systemic symptoms like
    • fever
    • malaise
    • headache
  • Rash
    • Unilateral dermatome
    • Blisters (vesciles) to crusts in varying stages
59
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Shingles complications

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  • Postherpetic neuralgia
  • Ocular movement (fifth cranial nerve)
  • Bacterial superinfection
  • Disseminated zoster
60
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Shingles overview

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61
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Herpes Zoster AKA

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Shingles

62
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Herpes AKA

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  • HSV-1

or

  • HSV-2
63
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Herpes clinical manifestations

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  • 1st infection has associated fever, achiness, headache, lymphadenopathy
  • Recurrent outbreaks with tingling or pain in skin
  • Rash
    • Vesicles that open to painful ulcers that heal 2-4 weeks
64
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Herpes complications

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  • Aseptic meningitis
  • Encephalitis
  • Blindness
  • Disseminated infection if immunocompromised
65
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Molluscum contagiosum clinical manifestations

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  • Rash
    • 2-5 mm painless
    • flesh colored, pearly papules with a central umbilication
    • Resolves in 6-12 months to 4 years
66
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Molluscum contagiosum complications

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  • Scarring if manipulated
  • Bacterial superinfection
67
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Molluscum contagiosum overview

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68
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Question

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69
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What is Erysipelas?

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Bacterial skin infection of the upper dermis

70
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Erysipelas clinical manifestations

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  • Very erythematous, indurated plaque with a sharply demarcated border
  • Typically associated with Group A Streptococcus (Though other bacteria are also implicated)
  • Previously associated with the face but now more commonly on legs
71
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What is cellulitis?

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  • A non-necrotizing inflammation of skin and subcutaneous tissues from acute infection
  • Typically from a break in the skin
72
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Cellulitis clinical manifestations

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Symptoms of

  • erythema
  • swelling
  • pain
  • warmth
73
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Cellulitis pathogens

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Staph aureus (including MRSA) and streptococcus are most common

74
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Cellulitis complications

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If left untreated, may progress to deeper infection or bloodstream infection

75
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Cellulitis overview

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76
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What is Necrotizing fasciitis?

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Infection that spreas along fascial planes, causing tissue necrosis

77
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Necrotizing fasciitis pathogen

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Typically Group A Streptococcus but also Staph aureus, Clostridium species or polymicrobial species

78
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Necrotizing fasciitis clinical manifestations

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  • Patients have intense pain compared to the appearance of the skin
  • They are also quite ill with fever, tachycardia
  • Skin eventually develops blisters, clear fluid drainage and crepitus
79
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Necrotizing fasciitis Treatment

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  • Surgical for extensive debridement
  • Antibiotics are usually broad spectrum initially plus clindamycin to disrupt toxin production
80
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Necrotizing fasciitis overview

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81
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Furuncle, Carbuncle, Abscess overview

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82
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What is a Furuncle?

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Deep folliculitis typically caused by S. aureus

83
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What is a carbuncle?

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Cluster of furuncles connected to each other under the skin

84
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What is an abcess?

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Collection of pus causing swelling and inflammation (Often deeper than a furuncle or carbuncle

85
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Furuncle, Carbuncle, Abscess Treatment

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Drainage +/- antibiotics

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Infectious Disease (82 decks)

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