Disease



|Disease |Organism |Associated Features |Rash – Initial |Rash - Progression |

|BACTERIAL | | | | |

|EXANTHEMS | | | | |

| |Rickettisa rickettsii|Vector? ___________ |Blanching erythematous |Evolves into papules,|

| | | |macules |eventually become |

|________________ | | |Starts on wrists and |nonblanching |

| | |Pathogenesis?________ |ankles |(petechiae or |

| | | |Spreads to trunk |palpable purpura) |

| | | |Palms and soles involved|Face usually spared |

| | |Treatment? __________ | | |

| |Neisseria |Purpura fulminans | |Necrosis of large |

| |meningitidis | | |areas of skin |

|_____________ | | |_____________ | |

| | | | | |

| | | | | |

| | | |_____________ | |

| | | | | |

| | | | | |

| | | | | |

| | | | | |

| | |Toxin? ___________ |Diffuse erythema |Rash lasts ~1 week, |

| | | |(sandpaper-like rash) |then desquamates |

|____________ |_________ | |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?)______ | |

| | | |______________ | |

| | | | | |

|Toxic Shock Syndrome | |Toxins?______________ |Diffuse macular | |

| |___________ | |erythrodermatous rash |___________ |

| | |___________________ | | |

| | | | |____________ |

| | | | | |

|VIRAL EXANTHEMS | | | | |

| | |What is the Prodrome? How long does|Erythematous |After 3-5 days rash |

|_____________ |___________ |it last? |maculopapular eruption |fades becoming copper|

| | | |begins behind the ears |brown and then |

| | |____________________ |and forehead, progresses|desquamating |

| | | |to neck then spreads to| |

| | | |face, trunk, upper | |

| | |____________________ |extremities, buttocks, | |

| | | |and lower extremities | |

| | | |(cephalocaudal spread) | |

| | |How long does the Exanthem phase |involves palms and soles| |

| | |last? | | |

| | |___________________ |Koplick spots –Describe | |

| | | |what they are? _______ | |

| | |___________________ |____________ | |

| | | | | |

| | |Prodrome malaise, tender |Pink-red maculopapular |Rash lasts 3-5 days |

| | |lymphadenopathy |eruption beginning on |and may desquamate |

|_______________ |___________ |(mostly cervical, suboccipital, and|face and neck ,then | |

| | |postauricular) |spreading to trunk and | |

| | | |limbs | |

| | | | | |

| | | |Forchheimer Spots – | |

| | | |Describe what they are? | |

| | | |____________ | |

| | | | | |

| | | | | |

| | | | | |

| | | | | |

| | |Most common childhood exanthem |2-5mm pink, rose colored| |

|_____________ |____________ | |macules |___________ |

| | |Abrupt onset high fever,children | | |

| | |defervesce on 4th day coinciding |Starts on trunk, may | |

| | |with onset of rash |spread to neck and upper| |

| | | |and lower extremities | |

| | | |+scalp involvement | |

| | |What is a complication in patients |Slapped cheek appearance|After rash fades, |

| | |with hemolytic anemia? |on day #1 |lacy marble like |

|______________ |___________ |_______________ |Erythematous, lacy |pattern to skin |

| | | |macular eruption starts |appears, can last up |

| | | |on truck spreads to |to several weeks, |

| | | |extremities |worsen with heat or |

| | | | |sunlight |

| | |Pathogenesis?__________ |Initial lesions |New lesion |

| | | |generally occur on trunk|development stops by |

|_______________ |___________ |___________________ |(centripetal |day #4, crust by day |

| | | |distribution) and |#6 |

| | | |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) | |

| | |Associated vasculitis - risk for |Oral mucosal changes |Desquamation of |

|_______________ |___________ |coronary artery aneurysm |(ulcers): Strawberry |fingertips |

| | | |tongue, fissured lips | |

| | |Cervical LAD most common physical | | |

| | |manifestation |Polymorphous exanthem | |

| | | |(usually in truncal | |

| | | |region) | |

| | | | | |

| | | |Erythema/edema of hands | |

| | | |and feet | |

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INFECTIOUS EXANTHEMS

Students should complete the table to help with their USMLE preparation

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