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    Common Rashes

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    may0s910
    This document provides guidance on evaluating and diagnosing rashes in children. It describes the approach of assessing the child's overall wellness, rash history and characteristics. It then reviews the classic childhood rashes like measles, rubella and varicella, detailing their features. Management advice is provided for conditions like Kawasaki disease, scarlet fever and hand foot and mouth disease. Distinguishing potentially dangerous rashes from self-limiting viral exanthems is a priority, with referral suggested if a "killer rash" is suspected.

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    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd

    Common Rashes

    Uploaded by

    may0s910
    141 views73 pages
    This document provides guidance on evaluating and diagnosing rashes in children. It describes the approach of assessing the child's overall wellness, rash history and characteristics. It then reviews the classic childhood rashes like measles, rubella and varicella, detailing their features. Management advice is provided for conditions like Kawasaki disease, scarlet fever and hand foot and mouth disease. Distinguishing potentially dangerous rashes from self-limiting viral exanthems is a priority, with referral suggested if a "killer rash" is suspected.

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    This document provides guidance on evaluating and diagnosing rashes in children. It describes the approach of assessing the child's overall wellness, rash history and characteristics. It then reviews the classic childhood rashes like measles, rubella and varicella, detailing their features. Management advice is provided for conditions like Kawasaki disease, scarlet fever and hand foot and mouth disease. Distinguishing potentially dangerous rashes from self-limiting viral exanthems is a priority, with referral suggested if a "killer rash" is suspected.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    141 views73 pages

    Common Rashes

    Uploaded by

    may0s910
    This document provides guidance on evaluating and diagnosing rashes in children. It describes the approach of assessing the child's overall wellness, rash history and characteristics. It then reviews the classic childhood rashes like measles, rubella and varicella, detailing their features. Management advice is provided for conditions like Kawasaki disease, scarlet fever and hand foot and mouth disease. Distinguishing potentially dangerous rashes from self-limiting viral exanthems is a priority, with referral suggested if a "killer rash" is suspected.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 73

    Approach to Rash

    What else is wrong?


    Is the child well or unwell?
    History of rash and evolution
    Describe the rash colour, blanching, size,
    distribution, raised
    Is it a killer rash?
    Is it a classic rash rash of childhood?
    Management advice and follow up as
    appropriate

    Meningococcus

    Rare ~ 1:100,000, sporadic epidemics


    50% in < 2yrs, 25% > 30
    Wide clinical spectrum
    May mimic viral illness early
    Limb pain, myalgia, refusal to walk,
    cold hands and feet early signs 1
    Red rash initially -> petechiae ->
    purpura
    1. Inkelis SH, O'Leary D, Wang VJ, Malley R, Nicholson MK, Kuppermann N., Extremity pain
    and refusal to walk in children with invasive meningococcal disease. Pediatrics. 2002
    Jul;110(1 Pt 1):e3

    Enteroviral
    Rash
    Maculopapular
    Petechiae
    Includes many viruses
    Coxsackie, Echo,
    poliovirus etc

    Hand Foot and Mouth


    Brief prodrome
    Mild fever, mouth
    pain
    Rash/lesions
    Mouth
    Palms
    Sides of feet + soles
    Buttocks/nappy area

    Hand Foot and Mouth


    Advice?
    Highly contagious
    Handwashing
    Mx
    Symptomatic
    Xylocaine viscous
    Cautious use in young
    children due to risk of
    toxicity

    Erythema Multimforme

    Stevens Johnson
    Syndrome

    Stevens
    Johnson
    Syndrome

    Urticaria

    Urticaria

    Urticaria

    www.allergy.org.au

    Blanching
    Wheals
    Itchy
    Pink
    Raised
    Demarcated
    Transient
    Advice?

    Kawasaki Disease

    Need fever + 4 criteria

    1. Fever lasting 5 days


    2. Bilat conjunctival
    injection
    3. Erythematous rash
    4. Dry/red fissured lips
    or strawberry tongue
    + red oropharynx
    5. Oedema of hands/feet
    desquamation
    6. Cervical LNs at least 1
    = >1.5cm

    Kawasaki Disease
    Advice?
    Ix?
    Mx?

    Algorithm for incomplete KD


    Patient characteristics suggesting disease
    other than Kawasaki disease:
    exudative conjunctivitis,
    exudative pharyngitis,
    discrete intraoral lesions,
    bullous or vesicular rash, or
    generalized adenopathy

    American Heart Association (AHA) and the American


    Academy of Pediatrics (AAP)
    http://www.uptodate.com/contents/incomplete-atypica
    l-kawasaki-disease?source=see_link

    Scarlet Fever
    Rash
    Often first on head and
    neck
    Most prominent
    axillae/groin
    Then trunk + limbs
    Palms/soles are spared
    Erythematous
    Maculopapular
    Sandpaper

    Scarlet Fever
    Incub period 2 days
    Prodrome
    Tonsillitis
    Rash
    Flushed face
    Circumoral pallor
    Strawberry tongue

    Scarlet Fever
    Advice ?
    Infectious until
    Pen is
    given for 24
    hours

    Scarlet Fever

    Desquamation after one week

    Scarlet Fever

    Measles
    Rash
    Maculopapular
    Morbilliform
    Starts behind ears
    Then face, trunk, incl.
    palms/soles
    (cephalocaudal spread)
    Fades by 4-5 days
    Then brown staining
    No desquamation

    Measles
    Prodrome
    3-5 days
    Kopliks spots
    Runny nose
    Conjunctivitis
    Dry cough
    High fever/chills
    Malaise/headache
    SYSTEMIC TOXICITY

    Rubella
    Rash
    Pink maculopapular
    Starts on face, behind
    ears
    Then trunk, limbs
    Disappears over 2-3/7
    Petechiae soft palate
    (Forchheimer spots)

    Rubella 3rd disease


    Prodrome
    Lymph nodes may
    appear before rash
    Rash
    Mild illness
    Absence of high fever
    Advice?
    Infectious period 1-2
    weeks before rash 5
    days after

    Congenital Rubella

    Erythema
    Infectiosum/Slapped Cheek
    5th Disease
    Rash 3 phases
    Erythema/slapped
    cheek
    Maculopapular rash on
    limbs/trunk (next day)
    Reticulate/lacy
    pattern as rash fades
    (day 6)
    Duration of rash 3-24
    days

    Erythema Infectiosum
    Advice?
    Complics
    Arthritis/arthralgia
    Aplastic crises
    Fetal exposure
    Infectious period
    during prodrome
    only

    Roseola 6th Disease

    Advice?

    Prodrome
    Fever 3-5 days
    Irritable
    D+V, cough
    Rash after prodrome
    Maculopapular
    Well child once
    rash appears

    Classic Rashes of Childhood

    1st disease Measles


    2nd disease Scarlett fever
    3rd disease Rubella
    4th disease Dukes disease (virus
    never isolated)

    5th disease Slapped Cheek


    6th disease Roseola

    Varicella
    Incub period
    Prodrome
    Rash
    Initially macules
    Vesicles in 6-8 hrs
    Crops
    Starts trunk, face, scalp
    Intensely itchy
    Crust over 5-25 days

    Advice?
    Contagious 24 hrs before rash till all
    crusted
    Usually 5-7 days
    Incub period
    ZIG?
    Vaccine?
    Fetal exposure
    Complics?

    Congenital Varicella

    Varicella Impetigo

    Shingles

    Eczema Herpeticum
    HSV infection in
    eczematous skin
    Can be severe
    Often need IV
    acyclovir
    Most resolve
    without sequelae

    HSV

    Herpetic Whitlow

    Herpetic Whitlow

    HSV

    Drug Rash

    Ceclor
    Bactrim
    Sulphur
    Penicillin
    Amoxil/Ampi +
    EBV

    Molluscum

    Approach

    What else is wrong?


    Is the child well or unwell?
    History of rash and evolution
    Describe the rash colour, blanching,
    size, distribution, raised
    Is it a killer rash?
    Is it a classic rash rash of childhood?
    Management advice and follow up as
    appropriate

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