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Symptomatic treatment:
For fever: Sponging with tap water and antipyretics
but avoid over dosage and prolonged use.
For constipation, headache
Supportive measures:
Fluids for dehydrated patients
RASHES
Papulo-vesicular or bullous
eruptions
Petechial or hemorrhagic eruptions.
Ulcerative eruptions
Nodular eruptions.
INFECTIOUSE DISEASES
CAUSING MACULOPAPULAR
RASH
MEASLES
GERMAN MEASLES
SCARLET FEVER
ROSEOLA INFANTUM
ERYTHEMA
INFECTIOSUM
EBV(INFECTIOUSE
MONONUCLEOSIS)
OTHERS ENTEROVIRUS
or COXASACKIE VIRUD
INFECTIONS WITH RASH
Vesiculo-papular
Urticaria
Post-Allergen as
insect bite
Very itchy
papulesvesiclesex
co-riation and 2ry
infection
No scalp
No mm
Over the extensor
surfaces, palms, soles
C/P
Describe
distribution: maximum, other areas
Itchy
MM
Iry lesions
Macule: Flat lenticular size
circumscribed area (<5 mm- <1cm)
of change in skin color
Papule: small lenticular size (<5mm-
1cm)
Circumscribed elevation of the skin
Nodule: Solid, circumscribed elevation
of the skin whose greater part is beneath
skin surface (felt more than seen)
Vesicle: collection of clear fluid
(<5mm in diameter)
Telangectasia:
Dilated capillaries
visible on skin
surface
Maculo-papular DD
What is the lesion
24 hours.
The rash starts by small red papules infective
that pass into vesicles on an
erythematous base.
It starts on the trunk and spreads to
the face, scalpNON
and extremities.
infective
Pruritis is usually present. Vesicles
produce a crust that falls with no scar.
Varicella CP
1- Prodroma: mild
2- rash:
skin: pleomorphic,
centripetal
itchy
tear drop
vesicles, scabs
mm: conj, oral, vagina
Chicken Pox
Pleomorphic:
pleomorphic
macules
papules
tear drop vesicles
scabs (crusts)
Chicken Pox
pleomorphic
Start at trunk
Then face and scalp
centripet
al
centripetal
Start at trunk
Then face and scalp
Mucus Membrane
It is a droplet infection and infectivity occurs 24
hours before, and up to scaling of all rash
( usually 7 days after the appearance of the
characteristic rash) . Dry scales are non-infective.
VARICELLA /ZOSTER
INFECTIONS
NEONATAL VARICELLA
Complications
Skin: 2ry bacterial infection Hgic varicella
Blood complications: ITP, internal hge, purpura
fulminans
CNS: encephalitis, cerebellitis, transverse myelitis,
GBS, cranial ns palsy as optic neuritis or bells
Respiratory: laryngitis, virus pn
Liver: Reye, hepatitis
Heart: all 3
Renal: GN
Extremities: arthritis , myositis
Eyes : keratitis
TT of Varicella
(Chickenpox)
1- non specific
2- specific: acyclovir
3- complications treatment: AB, IV
acyclovir REYE SYNDROME
See stomatitis DD
WHAT IS THE LESION
IP: 10 days
Maculopapular Rash
Measles GM R infant E infect Scarlet
AE RNA virus
IP 1-2 wk (10d)
CPT RESP/
CNS/SKIN/ITP/GIT/AN
ERGY
TT NON SPECIFIC
isolation
From 4 days (2
to 5 days) before the
rash appears
until about 4
days after the
rash has started
which is often when
it starts to
disappear
RASH
( on the 5th day of the illness )
Exanthem stage :
Fever
Rash :
Type :
Maculopapular
rash
Site: general
mainly at the
hair line of face
forehead
back of the neck
behind the ears
Rash
appears around the
fifth day of the disease
may last 4 to 7 days
usually starts on the
head and spreads to
other areas,
maculopapular rash
appears as both
macules (flat,
discolored areas) and
papules (solid, red,
elevated areas) that
later merge together
(confluent)
( on the 5th day of
the illness )
RASH
shape
Blotchy
Irregular
Large red patches
Varying size and
shape
Characteristically
coalesces
(geographic
pattern}
With mild itching
End by
Desquamation : (Branny)
Measles
I Day Before the Rash
Measles Rash : Face
Measles Rash
On Dark Skin
MEASLES
End by
Desquamation : (Branny)
How to manage Measles
PROPHYLAXIS:
- Hemorrhagic rash
- Bleeding from 6- Impaired
mucus membranes immunity .
GERMAN MEASLES
AE RNA virus
transm Droplet
Intrauterine
IP 2-3 w
Prodrom No/mild cc + LN
enanthm Mild
exanthm Mild
CPT Cong
infection/ITP/arthritis/CNS
TT NON SPECIFIC
See later
5
th disease
What is your Diagnosis?
A 5-year-old boy presents
to clinic with an afebrile
rash involving his
extremities and trunk for
three days . Past history
revealed the boy had mild
fever that resolved without
sequelae one week prior.
His rash began three days
prior with flushed cheeks
and then spread
ERYTHEMA INFECTIOSUM
('slapped cheek')
transm DROPLET
IP 1-2 WK
TT Asymptomatic
IV IgG in aplasia
PROPH
Fifth disease ('slapped cheek')
Erythema Infectiosum
Parvovirus B19 (DNA)*
A contagious and
usually mild illness
that passes in a couple
weeks,
Spread by coughing
and sneezing, it's most
contagious the week
before the rash
appears
starts with flu-like
symptoms,
followed by afebrile
, asymptomatic
rash:
1st stage: a face
slapped
cheeks with
circum-oral pallor
2nd stage: body rash.,
reticulated lacy
erythematous
eruption on the
proximal extremities,
buttocks and trunk
The third phase
lasts one to three
weeks and consists
of the reticulated
lacy lesions
intermittently
recurring especially
when provoked by
warm temperature,
sunlight, emotion or
exercise
Treatment
rest, fluids, and
pain relievers (do
not use aspirin if
your child has
fever), but watch
for signs of more
serious illness
6
th Disease
ROSEOLA INFANTUM
6th
transm droplet
exanthm Generalized MP
No post stain
LN
CPT 1- FC
2- Encephalopathy
TT Asymptomatic
Gancyclovir : immune deficiency,
encephalopathy
PROPH
6 th
Human Herpes
Viruses 6*
IP: 10 day
Age
Most cases present
within the first 2
years of life, with
peak occurrence in
infants aged 9-21
months.
F Seizures (6-15%)
CP Diarrhea (68%)
Cough (50%)
TT AB FOR 10 DAYS
SYMPTOMATIC
Better felt
Sandpaper like
Fade on pressure
Generalized Erythema
Finely nodular
erythematous rash
with
sandpaper or
goose-flesh texture
End by
Desquamation
peeling
Treatment
1- specific: AB for 10 days
2- non specific
3- treatment of complications
Complications:
ACUTE LATE
1-Local 1- A
Rheumatic F
2-Systemic 2- ADGN
Maculo - Papular Rash
Measles GM E infect R infant Scarlet
transm droplet
enanthm Koplick,s no
Rash Rainbow
RED TONSILS WITH strawberry tongue
Without After
fever storm
Treatment
Symptomatic and supportive.