Pediatric rashes: Difference between revisions

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==Measles (Rubeola)==
''This page is for pediatric patients; for other age groups see [[general approach to rashes]] and [[neonatal rashes]]''
*10d incubation period
==Background==
*3d prodromal period
{{Primary derm lesions names}}
**URI symptoms: fever, cough, conjunctivitis, coryza
{{Rash red flags}}
*Rash
**Begins 14th day after exposure
**Spreads from central to peripheral
**Initially is erythematous and maculopapular; rapidly progresses to confluence (face)
**Lasts 7d
**Koplik spots
***Pathognomonic enanthem
***White to bluish-white lesions w/ red base on buccal mucosa


==Scarlet Fever==
==Clinical Features==
-Incubation of 2-5days then...


-fever, HA, sore thrt, vomiting prodrome 12hrs before rash
==Differential Diagnosis==
{{Peds Rash DDX}}


-Erythematous, punctiform that blanches w/ pressure, starts on flexor areas then spreads to generalized in 24hrs.
==Evaluation==
{{Pediatric rashes images}}


-Forehead & cheeks smooth red flushed but circumoral pallor.
==Management==


-See lesions most on neck, axilla, inguinal area, popliteal folds
==Disposition==


-INVOLVES HANDS & FEET unlike measles
==See Also==
*[[Neonatal Rashes]]
*[[Rashes]]


-Desquamation follows
==References==
<references/>


-STRAWBERRY TONGUE IS PATHOGN.


-Etiol: Grp A strep.
[[Category:Pediatrics]]
 
[[Category:Dermatology]]
-Rx= pcn for 10 days or bicillin IM x1
[[Category:Symptoms]]
 
==Rubella (German Measles)==
*Incubation 2-3wk
*Prodrome 1-5d
**Fever, malaise, headache, sore throat
*Rash
**May be short-lived or protracted (2-3d)
**Pink macules/papules on face, spreads to neck, trunk, arms
***Coalesces on face as it reaches the lower extremities
*Lymphadenopathy
**Suboccipital and posterior auricular nodes
 
==Erythema Infectiosum (Fifth disease)==
*Caused by parvovirus B19
*"Slapped cheeks" rash
**Abrupt appeance
**Spares eyelids and chin
**Lasts 4-5d
*Macular erythema develops on trunk/limbs 2d after apperance of facial rash
**May last 1wk
*Assoc symptoms include fever, HA, sore throat, cough, coryza, N/V
 
==Roseola Infantum (exanthem subitum)==
*Likely caused by HHV-6
*3-5d prodrome of high fever, then defervescence, then rash for 1-2d
*Rash
**Erythematous macular eruption of discrete, pink lesions
**Mostly on neck, trunk, buttocks
**No mucus membrane involvement
 
==Enteroviral Infections==
*Includes echovirus and coxsackie
*Rubella-like appearance of rash w/ discrete maculopapular nonpruritic rash
*No specific therapy; self-limited
===Hand Foot Mouth Disease===
*Caused by coxsacke virus
*Brief prodrome w/ low fever, anorexia, sore mouth
*Oral lesions appear 1-2d later
**Vesicles on erythematous base
**Painful
*Hand/foot lesions
**Red papules that change to gray vesicles
===Herpangina===
*Caused by coxsackievirus
*Whitish ulcers on soft palate and posterior pharynx
**Similar to hand, foot, mouth disease but w/o skin lesions
 
==Varicella==
*Pruritic generalized vesicular exanthem w/ mild systemic manifestations
*Usually affects children <10y
*Rash
**Starts on trunk or scalp as pruritic, red macules, spreads to extremities
**W/in 24hr rash becomes vesicular (on erythematous base)
**Palms/soles spared
**Lesions in various stages of development
**Contagious until last lesion crusts over
*Treatment
**Tylenol, antihistamine
**Immunocompromised: IV acyclovir or high-dose PO tx (600mg/m2/day)
 
==HSV==
*Herpes labialis (cold sore)
*Herpes gingivostomatitis
*Herpetic whitlow
**Ensure that has not spread to cornea
*Eczema herpeticum
**Development of vesicular eruptions in areas of epidermis previously affected by eczema
**May be life-threatening
**Bactrim 10mg/kg/d in 2 divided doses OR clindamycin 24mg/kg/d divided into 3 doses x10d
**Acyclovir 80mg/kg/d in 3 divided doses x10
 
==Infectious Mononucleosis==
-abrupt or insidious, ha, fever & malaise common w/ st & lad to follow
 
-rash in 10-15% usu btwn 4th-6th day of illness
 
-red macular or maculopapular morbilliform rash of trunk & upper arms
 
-occ involves face, thigh & legs, periorbital & eyelid edema in 50% of cases
 
-pathognomonic= st, lad, splenomegaly, d/t EBV
 
==HSP==
-palpable purpura in lower ext and buttocks
 
==Drug Rash==
-sudden, usus morbilliform, often starts on face & trunk & spreads
 
==Source==
Tintinalli
 
[[Category:Peds]]
[[Category:Derm]]

Latest revision as of 16:59, 29 October 2016

This page is for pediatric patients; for other age groups see general approach to rashes and neonatal rashes

Background

Dermatology Nomenclature

Small lesions (<0.5cm)

Name Raised/Palpable Fluid-Filled Other Description Diagram
Macule No None flat, cirumscribed, colored Macule.png
Papule Yes None Solid Papule.png
Vesicle Yes Clear Vesicles (2).png
Pustule Yes Pus Leukocytes or keratin Pustules.png

Large lesions (>0.5cm)

Name Raised/Palpable Fluid-Filled Other Description Diagram
Patch No None Large macule (flat, colored) Patch.png
Plaque Yes None Superficially raised, circumscribed solid area Plaque.png
Nodule Yes None Distinct large papule Nodules.png.png
Bulla Yes Clear Large vesicle/blister or exposed epidermal layer Bulla.png
Wheal Yes Edema Firm and edema of dermis

Other

Ulcer, fissue, and erosion

Rash Red Flags[1]

Clinical Features

Differential Diagnosis

Pediatric Rash

Evaluation

Pediatric rashes visual diagnosis

Management

Disposition

See Also

References

  1. ↑ Nguyen T and Freedman J. Dermatologic Emergencies: Diagnosing and Managing Life-Threatening Rashes. Emergency Medicine Practice. September 2002 volume 4 no 9.
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