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DIFFERENTIAL DIAGNOSIS
Presence of Fever
The potentially life-threatening rashes ( Table 88.2 ) are all acute illnesses most
commonly associated with fever and significant systemic symptoms. Erythema
multiforme and rubeola have recognizable clinical appearances, whereas
Kawasaki disease, RMSF, and dengue fever require a high level of clinical
suspicion. Drug hypersensitivity reactions can often cause fevers.

Potentially Life-threatening Illnesses
Drug Hypersensitivity Reactions
Please see Chapter 68 Rash: Drug Eruptions for a full discussion of drug
reactions. The spectrum of cutaneous drug eruptions ranges from the relatively
benign to the severe. Morphology of the eruption as well as suspected drug
causing the eruption helps establish when clinicians should worry about
morbidity and mortality. Morphologies range from urticarial to morbilliform
(sometimes called maculopapular) to pustular and vesiculobullous. Many drug
hypersensitivity reactions are associated with fever.

FIGURE 88.19 Schematic approach to morbilliform or mixed macular and papular eruptions.