Viral Exanthems

Question 1

What are some erythmatous Exanthems that tend to start on the face?

Answer 1

Measles, rubella, erythema infectiosum

Question 2

What are some erythmatous Exanthems that tend to start on the trunk?

Answer 2

Roseola, scarlet fever

Question 3

What are some papulo-vesicular exanthems?

Answer 3

Chickenpox, gianotti-crosti syndrome

Question 4

What are some exanthems of the extremities?

Answer 4

Hand, foot and mouth disease, COVID-19, papular-pupuric gloves and socks syndrome

Question 5

Is measles a modifiable disease?

Answer 5

Yes

Question 6

What pathogen causes measles?

Answer 6

Paramyxovirus

Question 7

How long is the incubation period for measles?

Answer 7

7-18 days

Question 8

How is measles transmitted?

Answer 8

Airborne or droplet transmission

Question 9

How may a patient with measles present?

Answer 9

Rash is preceded by fever, cough and very red eyes. Older children may have photophobia. Rash is erythematous, maculopapular and last 4-7 days first on face then chest, abdomen, arms and legs. Koplik’s spots

Question 10

What are Koplik’s spots?

Answer 10

Small red spots with a bluish-white centre that appear on the mucous membranes of the mouth

Question 11

Is rubella a notifiable disease?

Answer 11

Yes

Question 12

How may a patient with rubella present other than the rash?

Answer 12

Prodromal symptoms occurring 1-5 days before rash of mild fever, conjunctivitis, tender post-auricular lymphadenopathy

Question 13

What is the rash like which is seen in cases of rubella?

Answer 13

Transient pink/light red rash that starts on face then moves onto trunk and limbs

Question 14

From when is someone with rubella infective?

Answer 14

From 1 week before the rash onset until 4 days after rash onset

Question 15

Why is important for people with rubella to avoid pregnant ladies?

Answer 15

If a pregnant lady gets infected their unborn baby may develop abnormalities

Question 16

What causes erythema infectiosum (slapped cheek syndrome) and how is it transmitted?

Answer 16

Parvovirus B19, transmitted by respiratory droplets

Question 17

How is a patient with erythema infectiosum likely to present?

Answer 17

Common in winter and spring, patient aged 4-10 years old. May have mild prodromal symptoms preceding the rash. Rash- confluent, erythematous, oedematous patches on the cheeks with sparing of the nasal bridge and periorbital areas which fades over a few days

Question 18

Until when is a child with slapped cheek syndrome infective?

Answer 18

They are no longer infective when the ras appears

Question 19

What causes roseola and how is it transmitted?

Answer 19

Human herpes virus 6 or 7, transmitted by airborne or droplets

Question 20

How will a patient with roseola typically present?

Answer 20

Child up to 3 years of age with high fever for a few days which settles as rash appears, abdominal pain and malaise. Occasionally URTI

Question 21

What is the rash like which is associated with roseola?

Answer 21

Small, pink/red macules spometimes with papules. First affecting trunk then arms and neck. Very little on face and legs. Lasts 1-2 days

Question 22

What causes scarlet fever and how is it transmitted?

Answer 22

Caused by streptococcus pyogenes, transmitted by aerosols and droplets

Question 23

Is scarlet fever a notifiable disease?

Answer 23

Yes

Question 24

How will a patient with scarlet fever typically present?

Answer 24

Child between 2-8 years with fever sore throat and headache. Rash on trunk rapidly spreading to other parts of body

Question 25

What is the rash like which is associated scarlet fever?

Answer 25

A fine, papular, erythematous rash that feels like sandpaper. As rash fades peeling affects the fingertips, toes and groin

Question 26

How can the tongue be affected in scarlet fever?

Answer 26

It gets a white coating which peels after a few days leaving the tongue red and swollen (known as strawberry tongue)

Question 27

What causes chickenpox?

Answer 27

Varicella-zoster virus

Question 28

How is chickenpox transmitted?

Answer 28

Transmitted through direct person to person contact, droplet or contact with infected items like clothing

Question 29

Where is the rash in chickenpox distributed?

Answer 29

Mostly over the trunk, more sparsely over the limbs

Question 30

What does the rash look like in chicken pox?

Answer 30

Crops of red flat macules which become raised then blister and crust

Question 31

Until when is chicken pox infective?

Answer 31

Until all the lesions have crusted over. The most infective time is 1-2 days before the rash appears