vary from simple one to an early sign of
a life-threatening condition .
Mostly due to infection .
Macule — Nonpalpable, circumscribed flat ,< 1 cm
Papule — Palpable ,solid, elevated, < 1 cm
Maculopapular -erythematous rash made up of both
macular and papular lesions.
Purpura — Papular or macular nonblanching lesions
Nodule — Deep-seated, roundish < 1.5 cm
Plaque — A palpable elevated > 1
Vesicle —elevated ,contains fluid ,<1 cm
Bulla —vesicle > 1 cm
Pustule —vesicle + pus
Characteristics of the lesions
Distribution and progression of the rash
Timing of the onset in relation to fever
Change in morphology, such as papules
to vesicles or petechiae
History (important clues)
Age of the patient
Season of the year
Exposures including to insects and ill
Immunizations and history of childhood
maculopapular rash beginning in the head
and neck area and spreading centrifugally
to the trunk and extremities;
fever, cough, coryza, and conjunctivitis
high-dose vitamin A does
seem to decrease the morbidity and mortality
is characterized by classic vesicular
lesions on an erythematous base that
appear in crops .
present in different stages from papules
through vesicles to crusting .
Don’t underestimate few vesicles in era of
Erythema infectiosum (fifth
Erythema infectiosum (fifth disease) is due
to human parvovirus B19.
rash with a "slapped cheeks" appearance
Treatment: supportive .
Pregnant and those with chronic hemolytic
anemia at high risk
Roseola infantum ( exanthem
a human herpesvirus 6 or 7 infection.
primarily seen in infants.
is characterized by high fever for three to
four days followed by generalized
maculopapular rash that spreads from the
trunk to the extremities .
Assosiated with febrile convulsion
Fever then rash not at same time
Caused by group A streptococcus (GAS)
manifested by a coarse, sandpaper-like,
erythematous, blanching rash.
This is accompanied by a strawberry
you will feel it
Acute rheumatic fever
The classic dermatologic manifestations of
ARF are erythema marginatum
transient macular lesions with central
clearing found on the extensor surfaces of
the proximal extremities and trunk.
Less than 5 %
a disease of unknown etiology.
is usually seen in children less than 5 years of
In addition to fever lasting >5 days,
bilateral conjunctival injection.
injected or fissured lips, injected pharynx or
'strawberry tongue' .
erythema of the palms or soles, edema of the
hands or feet or generalized or periungual
cervical lymphadenopathy . atypical
present with fever, sweats, anorexia,
nausea, chills, sore throat, posterior
cervical lymphadenopathy, splenomegaly,
and a maculopapular rash.
especially after the administration of
Gentle abdominal exam
In addition to fever, headache, and
Early lesions may be macular, but rapidly
increasing numbers of petechial or
purpuric lesions can develop on the distal
extremities and trunk, usually sparing the
palms and soles
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