Childhood Rashes

Mollusca contagiosa

  • Lesions are spherical and pearly white with central umbilication
  • Axilla, sides of trunk, lower abdomen, anogential region
  • 2-5 years old; heated pools; lesions last for weeks
  • Treatment: stay out of pools, will resolve spontaneously, may de-roof and wipe out contents if large

Atopic eczema

  • Generalized dryness, pruritis, erythema
  • Cheek, trunk, elbow, knee
  • Treatment: avoid triggers and dryness; moisturize; warm bath x 10 min and apply cream within 1 minute; may need steroids for flares

Measles

  • Blotchy, erythema, raised maculopapular – with desquamation
  • Bronchitis, exudative conjunctivitis, AOM, enanthem (Koplik spots)
  • Treatment: symptomatic

Rubella

  • Rash fainter and less florid than measles
  • Starts on face, profuse on trunk, sparse on extremities
  • Lymphadenopathy

Roseola – herpes virus 6

  • Fever, fever, fever, rash (maculopapular)

Erythema infectiosum – parvovirus B19, slapped cheek, fifth

  • Fever, cervical lymphadenopathy, facial rash
  • Lacy, reticular rash on limbs

Scarlet fever – group A strep

  • Pharyngitis (think about PSGN)
  • Strawberry tongue, sand paper rash, Pastia lines, circumoral pallor, cervical LA, peripheral desquamation

History

  • Immunizations/Immunity
  • Prodrome
  • Sick contacts
  • Travel

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