Rashes Flashcards
Immunisation schedule
UK Health Security Agency
-8 weeks
Erythema Marginatum
-10% kids; rare adults
-Trunk, UL and LL not face
-Flat rash, spreads circular fashion, centre fades. Irregular border
-Non itchy
-Last hours/ weeks/ months
-Group A strep
-Polyarthritis, carditis, Sydenham chorea
-Subcut nodules
-Short incubation
-Clinical diagnosis: cultures, ASOT (titre of antibody against strep), cardiological tests
-Treatment: penicillin (10 days)/ co-amoxiclav less frequently in liquid
M(ongolian) Blue Spots
-Dermal melanocytosis (can be congenital)
-Looks like ecchymoses/ bruise, fade by adolescence, irregular, flat, normal texture usually 2-8cm
-Less common in paler skins
-Base of buttock
-Document them in health record
Mottled skin/ cutis mamrorata
-Alternating constricted and dilated blood vessels, common
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Erythema multiforme
-Hypersensitivity
-Target lesion; mucous membrane involvement
-peripheral then spread centrally within 24 hours
-Centre of rash darkens; itchy
-Evolve over 72 hours; polymorphous
-Kobner phenomenon
-No swelling of face mucosal lesions after few days
-Fever child, painful joints
-HS: 2-14 days before. Mycoplasma, VZ, HIV
SJS and toxic epidermal necrolysis
-Prpbably variants of same condition
-Rare, acute, serious and poetntially fatal
-Skin and mucosal loss
-Vast majority caused by medicine
-SJSl: 1-2/million per year: TEN 0.4-1.2/million
Causes
-Antibiotics
Presentation of TEN
-Prodrome
=Fever, high, constant
=Cough, sore throat
=Runny nose, diff swallowing
=Aches and pains
-Rash
=Abrupt onset trunk face and limbs, macules red or purple, targets in EM, blisters merge to sheets which detach exposing leaking dermis
Diagnosis of SJS vs TEN
SJS:
-Skin detachment <10% BSA
=Erythema
Management of TEN
-Stop using drug ASAP
-Treat like burns patient
-Meticulous control of temperature, fluid and nutrition
-Pain relief
-Skin care )antisepctics, leave blisters, dressings)
-Urinary catheter
-Physio
-Eye: daily opthalamost assessment
Erythema nodosum
-Red lumps LL>UL, 6:1 women, hot red tender turns purple 2nd week
-Erupt for 10 days
-Joint aches (knees) last months
-Fever, unwell at time of rash
-Conjunctivitis
-Often preceded by sore throat 7-14 days before
-Infections: strep viral
Erythema infectiosum: Parvovirus B19
-Facial +/- circumoral pallor
-Macular papular lace like on trunk, itchy
-Moves to limbs
-Fever, headache, malaise
Hand Foot and Mouth disease
-Macules, papules- turn to grey vesicles surrounded by red halo; resolve spontaneously 7-10 daus; n scarring
-Oral lesions anyway hard palate)
-Papules and vesicles and ulcers; heal 5-10 days
-Skin lesions alongside or after
-2-5 days oral/ direct contact
HSV
-1: gingivostomatitis, oral ulceration vesicles
-2: genital (usually)
-2-14 days incubation
-Culture, PCR diagnosis
-Aciclovir, valaciclovir treatment
-Latent for life, conjunctivitis, men, enceph, CN palsies
-No immunisation, beware if HSV infants (SEM)
Larva migrans
-Anyone, at site of larvae penetration tingling: can lie dormant for months or progress. Creeping, itchy rash feet, knees, buttocks
-Parasite eggs in faeces of animals- soil- few days to few months