Pediatric emergency medicine trisk 1824 1824

TABLE 88.3
GENERALIZED RASHES THAT OFTEN HAVE CHARACTERISTIC
CLINICAL APPEARANCES
Rubeola
Erythema infectiosum (fifth disease)
Hand–foot–mouth disease (coxsackievirus A16)
Molluscum contagiosum
Scarlet fever
Pityriasis versicolor
Pityriasis rosea
Roseola infantum
Insect bites
Erythema multiforme
Stevens–Johnson syndrome
Drug reaction with eosinophilia and systemic symptoms
For patients with widespread rash who appear ill, consider drug
hypersensitivity reaction, or severe viral or bacterial infection. Figure 88.12 may
help with an approach to morbilliform/mixed macular and papular eruptions.
For patients who do not appear ill, certain exanthems will have distinctive
patterns that make the diagnosis readily apparent. Erythema multiforme, rubella,
coxsackievirus infections ( Fig. 88.14 ), erythema infectiosum ( Fig. 88.15A,B ),
scarlet fever, varicella, MC ( Fig. 88.16 ), tinea versicolor ( Fig. 88.17 ), pityriasis
rosea ( Fig. 88.18 ), and roseola all have recognizable clinical appearances. Many
of these illnesses have characteristic distributions or associated signs and
symptoms that aid in their diagnoses. If the pattern of the rash does not evoke
immediate recognition from the examiner, a more methodical approach is
indicated, as outlined in Figure 88.19 .