Pediatric rashes
Revision as of 21:06, 11 June 2012 by Rossdonaldson1 (talk | contribs) (moved Rashes (Peds) to Pediatric Rashes)
Measles (Rubeola)
Scarlet Fever
- Caused by GAS
- Prodrome of fever, sore throat, vomiting, abd pain followed by rash 1-2d later
- Rash
- Enanthem
- Tonsils/pharynx are red and covered w/ exudate
- Tongue may have initial exudate followed by erythema ("strawberry tongue)
- Soft palate have bright-red spots
- Exanthem
- Starts on neck, axillae, groin, spreads to trunk and extremities
- Red, finely punctate, sandpaper feel
- Desquamation follows
- Enanthem
- Treatment (to reduce rheumatic fever / nephritis)
- Penicillin VK 50mg/kg BID x 10d OR amoxicillin 40mg/kg/d in 2 divided doses x10d
- If pen allergic: Azithromycin 10mg/kg on day 1, 5mg/g days 2-5
Rubella (German Measles)
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
- Prodrome
- Sudden onset of high fever, sore throat, malaise
- Rash appears 24-48hr after prodrome
- Vesicles 1-2 mm in size that rupture leaving shallow, painful whitish ulcers on soft palate/posterior pharynx
- Similar to hand, foot, mouth disease but w/o skin lesions
- Lasts 7-10d
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
See Also
Source
Tintinalli