This document discusses the importance of pattern recognition in pediatric dermatology for emergency doctors. It provides several case studies of common pediatric skin conditions with details about the patient's age, symptoms, progression of rash, and location of lesions. Effective diagnosis relies on considering associated symptoms, age of the patient, evolution of the rash over time, and location of lesions on the body. Recognition of common pediatric skin conditions is important for emergency doctors to provide appropriate treatment or advice.

1. The common and the dangerous

2. 
Why does an adult ED Dr have to know;
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Common paediatric presentation
Useful knowledge for the lay consult
Frequent adult fast track patient presentation
Knowledge of at risk contacts
Recognition is 99% of the problem,
treatment/advice is usually simple

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Nomenclature of dermatology
Classification system of different rashes
Management

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Pattern recognition
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Age group
Progression of rash
Associated symptoms
Lesions
 Type
 Distribution
 Special features

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8yo, fever, headache then rash
Explosion of crops of lesions, first
face/scalp, then trunk and limbs over 1
day
Spares palms and soles

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10yo, coryza, conjunctivitis, cough, fever
Maculopapular rash, starts behing ears,
descends, becomes confluent on upper
body

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5yo girl, fever, arthralgias, malaise
Day 3 rash on face, fevers resolved
Day 7 lacy rash on body

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4yo boy
Fever, coryza, lethargy, mild diarrhoea
Painful lesions in/around mouth

21. 
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1yo, high fever, irritable
Day 3, florid rash, fever abates

26. 
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8yo, sore throat, fever
Day 2 – rash on trunk, spreads widely

32. 
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3yo girl, Asian descent
3 days high fever, irritable, rash = lower
abdo and groin, hands and feet
Mild transaminitis, high platelets

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4yo, non blanching rash on lower limbs
Painful feet, mildly swollen
Afebrile, systemically well
1 week post URTI

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14 yo girl, onset of rash over 1 week,
been present for 3 weeks
Seen 2 GPs
Systemically well, no other Sx

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5yo boy, African descent
Referred by GP with massive painless
abscess on scalp for surgical review
Systemically well

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3yo, 1 week post first coldsore
Onset of rash, mildly itchy, mild fever,
systemically well

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Progression of rash
Associated symptoms
Be a detective! Look in/at the;
• Mouth
• Hands and feet
• Nappy area and creases