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Approach to Common Pediatric Rashes .pptx
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- 2. RASH “Breaking out (eruption)of the skin” • Similar in appearance • Clinically indistinguishable
- 3. D/D • History - Infectiousdisease - immunization • Prodromal period - character - duration • Distribution and duration - discrete or confluent - central or peripheral • Pathognomonic features • Labs
- 4. Common Pediatric Rashes •Maculopapular rash • Papulovesicular rash
- 5. Maculopapular Rash • Measles •Rubella • Scarlet fever • Meningococcemia • Typhoid fever • Typhus fever • Rocky mountain spotted fever • Exanthem subitum • Erythema infectiosum • Drug eruptions
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- 7. Measles • Prodromal period –3-4 days of fever, cough, coryza & conjunctivitis • Rash – Begins on face, progresses downward towards feet – Koplik’s spot – Fever increases to 103-104 F – Disappears on 7th to 10th day
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- 9. Rubella • Prodrome - 1-4days - Fever & lymphadenopathy • Rash - rose pink - papular - Begins on face becoming generalized in 24-48 hours, disappearing on 3rd day
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- 11. Scarlet Fever • Rash -Occurs within 12 hours of onset of fever - Erythrematous, papular, sandpaper - Appears on flexor surfaces and becomes generalized within 24 hours - Flushed face, circum oral pallor • Desquamation involves hands and feet • Inflammed tonsils, coated tongue, strawberry tongue
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- 13. Meningococcemia • Fever, vomiting,irritability, headache, stiff neck • Rash appears within 24 hours - petichae or purpura - Ecchymosis - gangrene • Hemorrhagic eruption • Shock
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- 15. Typhoid Fever • Rosespots on lower chest and upper abdomen - blanch on pressure - disappear in 3-4 days - become brownish as they subside
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- 17. Exanthem subitum/Roseola Infantum •Prodrome – 3-4 days of high fever & irritability precedes – Fever subsides once the rash appears *Measles?? • Rash – Discrete, Rose red, Maculopapular – Appears on chest and trunk than involves face and extremeties – Disappears within 2 days
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- 19. Erythema infectiosum(Fifth disease) •No prodromal period • Afebrile patient develops asymptomatic rash – Slapped cheek appearence – Maculopapular eruption over upper & lower limbs – Evanescent stage characterized by subsidence of rash
- 20. Drug Eruption • Noprodromal symptoms • May simulate any rash • History of drug intake
- 22. Papulovesicular Eruption • ChickenPox • Small Pox • Herpes Zoster • Impetigo • Herpes Simplex
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- 24. Chicken Pox • Noprodromal symptoms • Rash – Papular eruption vesicular ruptures – Central distribution – Crusts in 24-48 hours – Multiple crops appear – Mucosa, Face and extremeties are involved – Crust fall off 1-3 weeks leaving no scar
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- 26. Small Pox • Prodrome –3-5 days of fever, chills – Headache & bachache – Severe malaise • Rash – Peripheral distribution on face & extremeties – All lesions are of same stage – Skin lesions are deep seated & umblicated
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- 28. Herpes Zoster • Painin the area of nerve distribution • Vesicles appear in clusters with unilateral dermatomal distribution • Lesions end abruptly in midline • Successive crops may appear
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- 30. Impetigo • GAS orStaph Aureus • Lesions are vesicular, become confluent • Rapidly progress to pustular & crusting phase • High fever • Local lymphnodes are enlarged
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- 32. Herpes Simplex • Noprodrome • Vesicles appear at the mucocutaneous junction of lips • Heal with crusting • Fever might me inciting factor
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