Fever and Rash - University of Massachusetts Medical School
Fever and Rash:
Common clinical syndromes
Christina Hermos, MD Primary Care Days April 10th, 2013 Westborough, MA
Approach to Patient with Fever and Rash
1. Description of Rash 2. Associated Signs and Symptoms 3. Exposures
Describe the Rash
? Timing ? Distribution
? Where did it start? ? Where has it spread? ? Does it move (evanescent) or not (fixed)?
? Symptoms
? Itching ? Pain ? Swelling
Describe the Rash
Characteristics and common terminology
? Type of lesion ? Macule (flat) ? Papule ? Nodule ? Vesicle ? Pustule ? Abscess ? Plaque ? Wheal
? Color ? Erythematous (red) ? Violacious (purple)
? Vascularity ? Blanching ? Petechiae ? Purpura ? Ecchymosis
? Arrangement/shape ? Scattered ? Grouped ? Well demarcated ? Morbilliform ? Coalescent ? Linear ? Annular ? Serpiginous ? Targetoid ? Lacey
? Consistency ? Desquamation ? Sandpaper ? Crust (scab)
Signs/Symptoms Associated with Rash
? Fever duration and characteristics ? Signs of shock
? Hypotension, poor perfusion, decreased consciousness
? Irritability ? Headache ? Respiratory symptoms ? Eye changes ? Mucous membrane lesions or pain ? Joint pain or swelling
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