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Differential Diagnosis of Rash Illness

DISEASE SIGN/SYMPTOMS TYPE OF RASH OTHER FEATURES


Measles
(10 day or hard
measles)
3-4 days of fever higher that
101F; red, watery eyes
which are very sensitive to
light; cough, runny nose,
tired
!ed, raised, "lotchy rash
which "egins on face and
nec#; s$reads slowly
downward, eventually
reaching the legs and feet "y
the %
th
day &y '-( days rash
is "rownish color, with
occasional $eeling
a$$earance
)ighly contagious, air"orne
s$read
*hite s$ots can a$$ear in the
mouth, on the inside of the
chee#s
!ash usually does not itch
+ ,mmuni-ation for $revention
very im$ortant
!u"ella
(3 day or .erman
measles)
/hildren may have few or no
early signs
0dults1 1-' days of low-grade
fever, headache, 2oint $ains,
runny nose, tired, red, watery
eyes 3wollen glands in nec#
or "ehind ears
4in# to red rash, "eginning on
head or nec# and s$reads
downward, fades and
disa$$ears in 3 days 5o
$eeling a$$earance
Many infections are so mild
they are unrecogni-ed
3erious concerns to $regnant
women as it may cause "irth
defects, therefore
+ ,mmuni-ation for $revention
very im$ortant
/hic#en $o6
(7aricella 8oster
virus)
.enerally low- grade fever for
1-3 days, loss of a$$etite,
headache
9arly rash a$$ears li#e insect
"ites, random sites,
$rogresses to red, raised
lesions with a small "lister in
center 5ew lesions a$$ear
daily for several days 0ll
stages of rash can a$$ear at
the same time :esions
usually crust and sca" within
'-10 days
:esions can a$$ear on the
scal$, in the mouth, ears,
genital regions and arm$its
;isease is s$read "y dro$lets
in the air and "y contact with
the watery "listers
3carlet Fever 1-3 days feeling very tired,
sore throat, fever, and
vomiting
Fine, "right, red rash that
"riefly turns white if you
$ress on it Most $rominent
on nec#, in arm$its, groin, or
folds in the s#in :ight
$eeling of s#in on hands and
feet 3and$a$ery, rough feel
to the rash
Face can "e flushed (red) with
white ring around the mouth;
tongue can swell and "ecome
coated with a <straw"erry=
a$$earance
+!elationshi$ of scarlet fever
and rheumatic heart disease in
untreated cases
+>reatment with anti"iotics
Fifth?s ;isease
(4arvovirus &1@)
&rief, nons$ecific illness
consisting of fever, malaise,
myalgias, and headache
Aften s$reads in e$idemics
among children
!ed, flushed chee#s,
reddened face with white ring
around the mouth, red lace-
li#e rash on trun# and
e6tremities :asting %-@ days
3unlight ma#es rash worse
Face has <sla$$ed chee#=
a$$earance
May fade and recur for few
wee#s
!oseola 3-' days of fever over 100BF,
can have runny nose, tired
3udden, raised, smooth rash,
which disa$$ears in C4 to 4D
hrs 3tarts on trun#, can
"ecome total "ody rash
!ash follows the fever
.enerally, mild illness
9nteroviral !ash
eg /o6sac#ie virus,
)and, Foot and
Mouth
3udden onset of fever to 103B
3ore throat, cold-li#e
sym$toms, headache, tired,
nausea, vomiting, diarrhea
!ed, raised rash, most on
trun# and face, may a$$ear on
$alms and soles !ash may
a$$ear with "listers in mouth,
fluid filled "um$s on hands,
feet !ash lasts 1-10 days
3everal different disease
syndromes may "e $resent E
common in children is )and, Foot
and Mouth disease
7irus shed in stool, good
handwashing im$ortantF
Differential Diagnosis of Rash Illness Page
DISEASE SIGN/SYMPTOMS TYPE OF RASH OTHER FEATURES
,m$etigo !ash a$$ears as little $in
si-ed <$im$les= "ut evolves
Guic#ly into ma2or s#in
eru$tions filled with $us
&egins as $in si-ed "listers
that "rea#, allowing the
discharge to s$read on the
s#in surface, causing s#in
"rea#down *hite or yellow
crust form at the sites, can
cover large areas if untreated
/hildren often have this rash
around the mouth $articularly
under the nose and chin
,m$etigo <itches=
)andwashing im$ortant
>reatment with anti"iotics
+)eat !ash+
(4ric#ly heat)
Aften a$$ears in moist s#in
folds of legs, arms, H nec#;
also at waistline and on
"uttoc#s
&ands or reddened areas or
$atches of reddened areas
)eat rash is a result of hot,
humid weather conditions and
the s#in contact with itself,
dia$ers or clothing Most often
associated with $lastic dia$er
$ants or dis$osa"le dia$er
$lastic irritating the s#in
surface and increasing
stimulus of sweat glands
;ia$er !ash !eddened s#in on "uttoc#s, or
<dia$er area= as a result of
irritation or infection from
stool, urine or $rolonged s#in
contact with $lastic dia$ering
materials ;evelo$s in moist
areas
!ash can "e generali-ed
reddened s#in surface,
evolving to "listered
a$$earance and s#in
"rea#down, with inflamed,
moist and "leeding $atches
>his rash causes discomfort
and $ain
< ;ia$er rash= can "e caused "y
$rolonged contact with soiled
dia$ers; however, some viral or
fungal organisms may cause sores
and "listering a$$earance
;rug or food
reaction
Accasionally fever, red, runny
eyes, sores in the mouth,
genital regions, and asthma
li#e sym$toms to e6treme
difficulty "reathing
!ash may a$$ear as raised
s#in areas li#e <welts= or as
<hives= in a cluster ,tching
usually $resent !ash may
a$$ear Guic#ly, may "e
isolated areas to a com$lete
"ody rash
;iscuss introduction of
medicines or new foods to
$revent further illness
/an a$$ear Guic#ly and "e
serious (>his rash a$$ears for
no other a$$arent reason)
3mall$o6 Fever for C-4 days "efore
rash, e6tremely ill
!ash starts with small "um$s
on face and u$$er arms, then
s$reads over the whole "ody,
more concentrated on
e6tremities and face >he
lesions "ecome "listered, then
filled with $us, then sca"
over
!ash is most often confused
with early chic#en$o6
Fever and severe illness for
several days "efore rash onset
suggests small$o6 and not
chic#en$o6

Differential Diagnosis of Rash Illness Page

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