3008 SKIN RASHES

Question 1

What are the 10 key rash history questions?

Answer 1

When did the rash start?
What was the initial location?
How did it spread?
Has it changed in nature?
What is its character (spotty, vesicles)?
Associated symptoms (pain, pins & needles)?
Severity of symptoms?
Timing and persistence of symptoms?
Is the rash permanent or intermittent?
Relieving/aggravating factors?

Question 2

How should you initially assess a rash?

Answer 2

Look at the rash and take a thorough history.

Emergency rash: review and admit.
Non-emergency rash: treat/support and send home.
Development timeline is key to diagnosis.

Question 3

What are the classic viral exanthems?

Answer 3

Measles
Scarlet Fever
Rubella
Erythema Infectiosum
Roseola

Question 4

Measles: Risk, Season, Infectious Period?

Answer 4

At risk: Non-immune individuals
Season: Late winter/spring
Infectious: 1–2 days before to 5 days after rash

Question 5

What are the key signs of measles?

Answer 5

Fever
Cough
Conjunctivitis
Malaise
Rash: Starts on head, maculopapular, coalesces
Koplik spots (white spots in mouth)

Question 6

Measles complications?

Answer 6

Encephalitis
Blindness
AKI (glomerulonephritis)
Diarrhoea
Pneumonia, croup, otitis media

Question 7

Scarlet Fever rash and symptoms?

Answer 7

Lacy, salmon rash
Feels like sandpaper
White patches
Fever, toxic look, lymphadenopathy, perioral pallor
Desquamation post-infection

Question 8

Scarlet Fever complications?

Answer 8

Rheumatic fever
PANDAS
Septicaemia
Toxic shock
Glomerulonephritis
Pneumonia, otitis media

Question 9

Kawasaki symptoms?

Answer 9

Fever >5 days
Rash
Swollen extremities
Conjunctivitis (non-purulent)
Cervical lymphadenopathy
Strawberry tongue, cracked lips

Question 10

Kawasaki management?

Answer 10

ECG
IV gamma globulin (Intragram)

Question 11

Rubella symptoms and rash?

Answer 11

Coryza, headache, conjunctivitis, joint pain
Rash: Starts on face, light pink/red, 2–3mm macules, lasts 3 days

Question 12

Congenital rubella complications?

Answer 12

Deafness, blindness
IUGR
Seizures, microcephaly
Blueberry muffin rash

Question 13

Erythema Infectiosum signs?

Answer 13

Slapped cheek appearance
Mild or asymptomatic in 50%
Risk: school children
Complications: aplastic anaemia, hydrops fetalis

Question 14

Roseola symptoms and rash?

Answer 14

Fever 3–4 days, then red papular trunk rash
Rash appears abruptly as fever defervesces
Rare to have it twice

Question 15

Causes of non-blanching rash?

Answer 15

Meningococcal sepsis
Henoch-Schönlein purpura (HSP)
ITP
Leukaemia
Non-accidental injury
Incidental petechiae

Question 16

Meningococcal symptoms?

Answer 16

Fever
Non-blanching rash
Shock
Vomiting
Rapid progression
Neck stiffness, seizures

Question 17

Treatment for meningococcal?

Answer 17

IV/IO antibiotics (Penicillin or Ceftriaxone)
IV fluids 10–20 mL/kg
Inotropes
Anticonvulsants if seizures
Staff PPE/prophylaxis

Question 18

HSP symptoms?

Answer 18

Petechiae/purpura on legs
Joint, abdominal, scrotal pain
Haematuria

Question 19

ITP signs?

Answer 19

Diffuse petechiae/purpura
Gum bleeding
Menorrhagia
Low platelet count

Question 20

Leukaemia signs?

Answer 20

Fatigue, fever
Large bruises
Low WBC
Abnormal bleeding

Question 21

HFMD symptoms?

Answer 21

Mouth ulcers
Rash on palms, soles, buttocks
Low-grade fever, malaise
Coxsackievirus A16

Question 22

Giannotti-Crosti signs?

Answer 22

Symmetrical papular rash
Face, buttocks, limbs
Often itchy
No treatment needed

Question 23

Molluscum contagiosum signs?

Answer 23

Umbilicated papules
Clusters or isolated
Spread by contact
Resolved on its own

Question 24

Staphylococcal Scalded Skin Syndrome?

Answer 24

Fever, irritability
Skin peels in sheets
Caused by staph toxins
Treat with antibiotics and wound care

Question 25

Chickenpox rash?

Answer 25

Small vesicles on red base Itchy, crusts over Complications: encephalitis, pneumonia

Question 26

Shingles features?

Answer 26

Follows dermatome Pain, tingling Does not cross midline Treat early with antivirals