Rashes

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Rashes

• Anya Freedman, MD
• July 24, 2006

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Eczema (childhood atopic dermatitis) key points

• Flexor surfaces
• Dry, scaly, pruritic
• Erythematous, weepy
• History of atopy (patient, family)
• Treatment
• Moisturizing lotions
• Topical steroids
• Avoidance of triggers

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Roseola key points

• Sudden onset of fever without other sx
• As high as 103 105 F
• Usually persists for 3 5 days
• Followed by rash typically simultaneous with
  resolution of fever
• Pale, pink almond-shaped macules, papules
• Truncal presentation with peripheral spread
• Non-pruritic
• Possibly associated with
• Febrile sz
• Lymphadenopathy, splenomegaly

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Coxsackie virus key points

• Mild prodrome
• Low grade fever, malaise
• Risk of dehydration
• Magic mouth wash
• Popsicles

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Scarlet fever key points

• Sudden onset of fever, pharyngitis
• Followed by nausea, abd pain, headache
• Rash appears 48 hours after onset of sx
• Spreads cephalo-caudally
• Sandpaper rash
• Pastias lines
• Treatment DOC is Amoxicillin

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Enterovirus key points

• Prodrome variable
• Timeline variable
• Rash variable
• Usually erythematous maculopapules
• May be vesicular, urticarial, petechial
• Associated symptoms variable
• Fatigue, low grade fever, nausea, abdominal pain,
  nausea, vomiting, diarrhea
• Treatment supportive

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HSP key points

• Frequent history of URI 1-3 weeks prior
• Rash often first presenting symptom
• Initially urticarial ? maculo-papular ? purpura ?
  palpable purpura
• Appears predominantly in dependent areas
• Leukocytoclastic on biopsy
• Associated symptoms
• Abdominal pain, hematuria

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Varicella key points

• Still present in age of vaccination
• Typical prodrome, time course no longer valid
• Risk of zoster in children who develop leukemia
  unchanged
• Symptomatic treatment
• VZIG indicated for pregnant women and
  immunocompromised contacts

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Molluscum contagiosum key points

• Discrete 2-5 mm slightly umbilicated,
  flesh-colored, dome-shaped papules
• Auto-inoculation common
• Multiple treatment options usually not
  indicated
• No need for CPS contact

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Scabies key points

• Nocturnal pruritus characteristic
• Autoinoculation
• Burrows
• Linear, curved or S-shaped
• Pink-white, elevated, tipped by vesicle or mite
• Most commonly found on finger webs, wrists, sides
  of the hands and feet, penis, buttocks, scrotum,
  and the palms and soles
• Secondary lesions common