MHD II, Session XII, Exanthems – Student Copy p. 1

Disease / Organism / Associated Features / Rash – Initial / Rash - Progression
BACTERIAL
EXANTHEMS
______ / Rickettisa rickettsii / Vector? ______
Pathogenesis?______
Treatment?______/ Blanching erythematous macules
Starts on wrists and ankles
Spreads to trunk
Palms and soles involved / Evolves into papules, eventually become nonblanching (petechiae or palpable purpura)
Face usually spared
______ / Neisseria meningitidis / Purpura fulminans / ______
______ / Necrosis of large areas of skin
______ / ______/ Toxin? ______/ Diffuse erythema (sandpaper-like rash) beginning on upper chest, spread to extremities
Most intense on inner aspects of arms and thighs
Palms and soles spared
______tongue
Circumoral pallor
Pastia lines (describe what they are?)______
______/ Rash lasts ~1 week, then desquamates
Toxic Shock Syndrome / ______/ Toxins?______
______/ Diffuse macular erythrodermatous rash / ______
______
VIRAL EXANTHEMS
______/ ______/ What is the Prodrome? How long does it last?
______
______
How long does the Exanthem phase last?
______
______/ Erythematous maculopapular eruption begins behind the ears and forehead, progresses to neck then spreads to face, trunk, upper extremities, buttocks, and lower extremities
(cephalocaudal spread)
involves palms and soles
Koplick spots –Describe what they are? ______
______/ After 3-5 days rash fades becoming copper brown and then desquamating
______/ ______/ Prodrome malaise, tender lymphadenopathy
(mostly cervical, suboccipital, and postauricular) / Pink-red maculopapulareruption beginning on face and neck ,then spreading to trunk and limbs
Forchheimer Spots – Describe what they are?
______/ Rash lasts 3-5 days and may desquamate
______/ ______/ Most common childhood exanthem
Abrupt onset high fever,children defervesce on 4th day coinciding with onset of rash / 2-5mm pink, rose colored macules
Starts on trunk, may spread to neck and upper and lower extremities
+scalp involvement / ______
______/ ______/ What is a complication in patients with hemolytic anemia? ______/ Slapped cheek appearance on day #1
Erythematous, lacy macular eruption starts on truck spreads to extremities / After rash fades, lacy marble like pattern to skin appears, can last up to several weeks, worsen with heat or sunlight
______/ ______/ Pathogenesis?______
______/ Initial lesions generally occur on trunk (centripetal distribution) and occasionally on the face
3- to 4-mm red papules and a clear vesicle on the surface
(dewdrops on a rose petal)
Pruritic initially
different stages of rash present simultaneously
(red macules, papules, vesicles, pustules, crust) / New lesion development stops by day #4, crust by day #6
______/ ______/ Associated vasculitis - risk for coronary artery aneurysm
Cervical LAD most common physical manifestation / Oral mucosal changes (ulcers): Strawberry tongue, fissured lips
Polymorphous exanthem (usually in truncal region)
Erythema/edema of hands and feet / Desquamation of fingertips