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Friday, 23 August 2019

Other Rashes

Chicken Pox
Often blistering and crusting.
Incubation 10-21days
Infectivity when symptoms start

Measles 
Starts from the top and moves down. Often associated with conjunctival problems.
Incubation 7 - 21days
Infective - before symptoms to four days after appearance of rash
Rash - maculopapular, spreads head downwards
One of cough, conjunctivities or coryza
- Get Koplik's spots, red throat
- throat swab
- notify if suspicious
- off school until 5 days after rash
- need immunoflobulin if under 12months, immunocompromised or pregnant.
- MMR if unimmunised within 72hours of exposure
MMR side effects are in the 2nd week after immunisation - fever and rash.

 Rubella or German Measles
It's benign and self eliminating.
- 2 week incubation
- headache, fever, lymphadenopathy
- infective 7 days efore, 7 days after onset of rash
- rash face down to feet
- fever, tender occipital and post auricular lymphadenopthy, arthralgia
- Forschheimer spots - pin-point red macules and petechiae, seen on soft palate and uvula
- Immuniglobulin G and M assays

Slapped Cheek / Parvovirus / Fifth Disease 

 Scarlet Fever
Pastias lines in the flexural folds with circumoral pallor, and pharyngitis. Desquamation of hands, feet and groin. Rash has a sandpaper-link quality.
-aerosol/droplet
- 2-5 days incubation
- infective 5 days from antibiotics
- sore throat, headache, fever, lymphadenopathy, malaise, abdopain. Sandpaper-like rash
  Strawberry tongue, pastias lines, circumoral pallor, pharyngitis, desquamation of hands feet and groin.
- notify clinical suspicion
- off school 5 days after antibiotics (HPA)
- for grop A strep tonsillitis 24hours off after antibiotics.

Roseola
The roseola rash often appears after the fever has settled.
Herpes virus
Fever + febrile illness
5-15days incubation
Respiratory illnesss, 3-5days fever, cervical lymphadenopathy
Rash from behind ears - blanching macules and papules surrounded by halos
Nagayama's spots- erythematous papules on the soft palate
Diarrhoea
Cough


Other References
https://www.rcemlearning.co.uk/foamed/7-pem-rashes/
https://www.rcemlearning.co.uk/reference/common-childhood-exanthems/
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