Pediatric emergency medicine trisk 1840 1840

The eruption consists of skin-colored papules that occur anywhere on the body
but often concentrate on the extensor surfaces of the arms, legs, and buttock.
Lesions are particularly prominent over the elbows and knees. The rash usually
lasts 2 to 8 weeks and then disappears. No treatment is needed for the cutaneous
eruption; however, a subset of patients with cutaneous lesions develops
generalized lymphadenopathy and hepatosplenomegaly. These children should be
evaluated for hepatitis and follow-up in 2 weeks is recommended for patients
with only cutaneous involvement to exclude hepatitis.
Scabies
Scabies is discussed in Chapter 70 Rash: Papulosquamous Eruptions and Viral
Exanthems .

Chronic Eruptions Without Fever
Chronic eruptions are defined as those that are usually present for a minimum of
2 weeks.
Atopic Dermatitis
Although the eruption may have a variable appearance (erythema, edema,
papules, vesicles, serous discharge, and crusting), its constant feature is pruritus.
The eruption often has a characteristic distribution, depending on age, and often
occurs in allergic (atopic) individuals or those with a family history of allergies
(e.g., hay fever, asthma, allergic rhinitis, food allergies, eosinophilic
gastroenteritis). Please see full discussion in Chapter 65 Rash: Atopic/Contact
Dermatitis and Photosensitivity .
Tinea
Dermatophyte infections usually last longer than 2 weeks. A full discussion can
be found in Chapter 66 Rash: Bacterial and Fungal Infections/Rash:
Maculopapular . In short, tinea corporis is characterized by one or more sharply
circumscribed scaly patches. The center of the circular patch generally clears as
the leading edge spreads out. The leading edge may be composed of papules,
vesicles, or pustules. The lesions are most commonly confused with nummular
eczema. The diagnosis can be made by scraping the active outer rim of papules

and examining the scales with a potassium hydroxide (KOH) preparation under
the microscope. These lesions do not fluoresce under the Wood light. Treatment
with topical antifungal agents such as clotrimazole, miconazole, econazole,
terbinafine, and butenafine produces clearing in 7 to 10 days. Therapy should be
maintained for at least 2 weeks. If improvement does not occur, treatment with