Generalised rash

MACULOPAPULAR

VESICULAR

HAEMORRHAGIC ** extravasated blood; do not blanch on pressure. Classified by size

URTICARIAL ** Urticaria (hives), transient, itchy rash raised weals, appears rapidly and fades; it can recur.

  • Enteroviral infx generalized, pleomorphic rash, mild fever.
  • Glandular fever : malaise, fever, exudative tonsillitis. +- Lymphadenopathy, splenomegaly
  • Kawasaki disease protracted fever, generalized rash, red lips, lymphadenopathy, conjunctival inflammation.

Viral exanthems

  • Measles (1) : fever, coryza, cough --> Koplik spots --> rash
  • Scarlet Fever (2) : fever, sore throat. Rash starts on face +- ‘strawberry’ tongue'
  • Rubella (3) : discrete, pink macular rash starts on scalp + face. Occipital + cervical lymphadenopathy may precede rash.
  • Roseola infantum (6) : <3 years. 3days fever --> temp drops --> pink morbilliform (measles-like) eruption. Due to HHV-6/7
  • Drug induced eruption?
  • Eczema Herpeticum : Herpes infx --> exacerbation of eczema = vesicular spots
  • Chicken pox : successive crops of papulovesicles on an erythematous base; vesicles become encrusted. Lesions present at different stages. Mucous membranes involved.

Petechiae (smallest).

Purpura.

Ecchymoses (largest)

  • Meningococcal septicaemia

Meningococcal septicaemia

  • Idiopathic thrombocytopenic purpura : child looks well, may have petechial rash +- nose bleeds.

Food allergy, (shellfish, eggs, CMA)

Drug allergy, (* < 10% penicillin allergies are unsubstantiated)

ERYTHEMA MULTIFORME
symmetrical rash, annular target (iris) lesions + other lesions (macules, papules, bullae). Mostly idiopathic and self-limiting.

  • Acute leukaemia : look for pallor and hepatosplenomegaly.

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  • Henoch–Schönlein purpura : Distribution: legs + buttocks. Arthralgia + abdominal pain might be present.

Bleeding disorders- usually present w/ easy bruising, prolonged bleeding following trivial trauma

  • Haemophilia
  • von Willebrand disease
  • Ehlers–Danlos

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(Most common) Infection viral:
often self-limiting.

Contact allergy

  • Stevens–Johnson syndrome ( severe form, mucous membrane involved)

Causes: infections (HSV, mycoplasma, EBV), drugs.

ERYTHEMA NODOSUM
Red, tender, nodular lesions usually occur on the shins.

Causes: streptococcal infection, TB.