11. Paediatric Rashes

Question 1

Roseola

(Description, S+S, Treatment, DDX)

Answer 1

Description:
* Roseola infantum common, mild, viral infection
* Can cause temperature and rash

Signs and Symptoms:
* Fever
* Sore throat
* Runny nose
* Rash to trunk

Treatment:
* Analgesia/ antipyretic (pts >3 months)
* Rest
* Oral rehydration

DDX:
* Measles
* Hand, foot and mouth
* Erythema

Question 2

Measles

(Description, S+S, Treatment, DDX)

Answer 2

Description:
* Viral respiratory illness
* Characterised by a prodrome

Signs and Symptoms:
* Fever
* Malaise
* Cough
* Coryza
* Conjunctivitis
* Koplik spots (white grain of sand surrounded by red ring located inside mouth)
* Bright red maculopapular rash all over body

Treatment:
* PPE
* Analgesia/ antipyretic (pts >3mths)

DDX:
* Roseola
* German measles

Question 3

Scarlett Fever

(Description, S+S, Treatment, DDX)

Answer 3

Description:
* Bacterial
* Develops in some people who have strep throat

Signs and Symptoms:
* Fine red rash – rough in texture, blanching, starts on chest
* Strawberry tongue
* Fever
* Swollen lymph nodes

Treatment:
* Analgesia/ antipyretic (pts >3mths)
* ABX

DDX:
* Measles
* Duke’s disease

Question 4

Rubella (German Measles)

(Description, S+S, Treatment, DDX)

Answer 4

Description:
* Viral
* Contagious
* Preventable by vaccine
* Distinctive red rash
* Important to vaccinate pregnant women as can cause birth defects

Signs and Symptoms:
* Fever
* Malaise
* Cough
* Coryza
* Koplik spots
* Generalised bright red maculopapular rash

Treatment:
* PPE
* Analgesia/ antipyretic (pts >3mths)

DDX:
* Measles
* Roseola

Question 5

Dukes

(Description, S+S, Treatment, DDX)

Answer 5

Description:
* Known as fourth disease
* Viral rash
* Commonly caused by enteroviruses, echoviruses and some coxsackievirus’

Signs and Symptoms:
* Fever
* N/V/D
* Viral SX
* Sensitivity to light
* Enlarged lymph nodes
* Sore throat
* Possibly brain inflammation

Treatment:
* Analgesia/ antipyretic (pts >3mths)

DDX:
* Measles
* Scarlett Fever

Question 6

Fifth’s Disease (Slap Cheek)

(Description, S+S, Treatment, DDX)

Answer 6

Description:
* Viral
* Caused by human parvovirus B19
* Respiratory transmission

Signs and Symptoms:
* Red cheeks (warm to touch)
* Feels well
* Afebrile

Treatment:
* Analgesia (pts >3mths)
* NSAID (pts >1yr)

DDX:
* Measles
* Rubella
* Scarlett Fever

Question 7

Herpes Simplex Virus

(Description, S+S, Treatment, DDX)

Answer 7

Signs and Symptoms:
* Vesicles
* Risk if near the eye as direct link to brain

Treatment:
* Analgesia (pts >3mths)
* NSAID (pts >1yr)

DDX:
* Candidiasis
* Hand foot and mouth
* Herpes Zoster

Question 8

Chicken Pox

(Description, S+S, Treatment, DDX)

Answer 8

Description:
* Highly contagious
* Viral
* Caused by varicella-zoster virus
* Contagious with open lesions (7-10 days)

Signs and Symptoms:
* Headache
* Malaise
* Low grade fever
* Lesions (vesicles) appearing over a 3 day period
* Can get skin infections

Treatment:
* Analgesia (pts >3mths)
* NSAID (pts >1yr)
* Comfort care (e.g. calomine lotion baths)

DDX:
* Herpes Simplex Virus

Question 9

Scabies

(Description, S+S, Treatment, DDX)

Answer 9

Description:
* Caused by mites burrowing into skin
* Highly contagious

Signs and Symptoms:
* Itchy rash
* Tracking
* Likes crevices of hands and feet

Treatment:
* PPE
* Antiparasitic scabies treatments

DDX:
* Sebhorric dermatitis

Question 10

Henoch Scholein Purpura

(Description, S+S, Treatment, DDX)

Answer 10

Description:
* Affects small blood vessels of skin, joints, intestines and kidneys
* Most common <7 yrs but can affect anyone

Signs and Symptoms:
* Purpuric (purple) rash mainly located on gravity areas e.g. bottom, lower limbs
* Fever
* Malaise
* Abdo pain

Treatment:
* Analgesia (pts >3mths)
* NSAID (pts >1yr)
* Hospitalisation may be required if renal involvement or uncontrolled pain

DDX:
* Meningococcal disease
* Kawasaki

Question 11

Impetigo

(Description, S+S, Treatment, DDX)

Answer 11

Paediatric Rashes

Impetigo

(Description, S+S, Treatment, DDX) Description:
* Mild infection
* Can occur anywhere in body
* Most often affects exposed skin (nose, mouth, arms, legs)

Signs and Symptoms:
* Red itchy sores that break open and leak clear fluid or pus for few days
* Leaves honey coloured scabs

Treatment:
* Analgesia (pts >3mths)
* NSAID (pts >1yr)
* Oral ABX

DDX:
* Dermatitis
* Herpes simplex virus
* Scabies