Viral Exanthems

Question 1

What is Varicella?

Answer 1

Highly contagious intraepidermal vesicular eruption

Question 2

What is Varicella caused by?

Answer 2

Varicella zoster virus

Question 3

T/F: A 2-3 day prodrome of H/A, fever, malaise, sore throat, anorexia, & cough precedes pruritic vesicular eruption in Varicella

Answer 3

True

Question 4

What does a Varicella rash look like?
What’s the buzzword?

Answer 4

• Polymorphic eruption of macules –> papules/vesicles/pustules –> necrosis, may be umbilicated
• “Dew drop on a rose petal” (vesicle with erythematous base)

Question 5

T/F: Rubeola “Measles” is preceded by a prodrome and often generalized LAD

Answer 5

True

Question 6

What are the 3 C’s of Rubeola “Measles”?

Answer 6

1. Cough
2. Coryza (rhinitis)
3. Conjunctivitis

Question 7

What does a Rubeola “Measles” rash look like?
What’s the distribution?

Answer 7

• Generalized erythematous maculopapular eruption
• Becomes confluent on head & trunk, remains discrete on extremities
• Starts behind ears –> trunk –> extremities

Question 8

Prior to the rash seen in Rubeola “Measles” pts get?

Answer 8

Koplik spots: tiny gray-white papules on erythematous base on buccal mucosa

Question 9

T/F Rubella “German Measles” is preceded by a prodrome and often strikingly large LN of the head & neck

Answer 9

True

Question 10

Rubella “German Measles” is spread via?

Answer 10

Respiratory droplets

Question 11

What does the rash in Rubella “German Measles” look like?
What’s the distribution?

Answer 11

• Maculopapular eruption
• Unlike Rubeola “Measles” lesions typically remain discrete in all areas and is less red/bright
• Red spots on soft palate
• Starts behind ears –> trunk –> extremities

Question 12

Complications of Rubella “German Measles”?

Answer 12

• Arthritis
• Congenital Rubella Syndrome (in babies born to a mother who was infected in 1st trimester)

Question 13

T/F: Roseola is preceded by a prodrome.

Answer 13

True

Question 14

This is the m/c viral exanthem in kids <2 y/o

Answer 14

Roseola

Question 15

Fever Fever Fever RASH

Answer 15

Roseola

Question 16

What does the Roseola (HHV-6) rash look like?
Where is it m/c located?
How long does it last?

Answer 16

• Discrete rose/red macules & papules
• Trunk & proximal extremities
• 24-48 hrs

Question 17

Complications of Roseola?

Answer 17

May cause febrile seizures newborns

Question 18

How do you treat Roseola?

Answer 18

SUPPORTIVE -self limiting

Question 19

What’s the causative agent for Erythema Infectiosum “5th Dz”?

Answer 19

Enterovirus (Parvo B19)

Question 20

What does the rash in Erythema Infectiosum “5th Dz” look like?

Answer 20

• Confluent erythema on cheeks
• Lacy reticular erythema on rest of body
• May be pruritic

Question 21

Slapped cheek appearance

Answer 21

Erythema Infectiosum “5th Dz”

Question 22

Complications of Erythema Infectiosum “5th Dz”?

Answer 22

• Arthritis
• Acute aplastic crisis in pts with chronic hemolytic anemia (sickle cell)

Question 23

How do you treat Erythema Infectiosum “5th Dz”?

Answer 23

Symptomatically
- Self limiting in young kids
- Need to be extra careful if pt is pregnant or has sickle cell

Question 24

T/F: Coxsackie “Hand Foot Mouth” is preceded by a prodrome

Answer 24

Ture

Question 25

What's the causative agent for Coxsackie "Hand Foot Mouth"?

Answer 25

Coxsackie virus A-16

Question 26

What does the rash in Coxsackie "Hand Foot Mouth" look like?

Answer 26

- Oral lesions that start as erythematous macules --> small vesicles on erythematous base --> ulcerate into painful lesions - Similar lesions on hands and feet

Question 27

How is Coxsackie "Hand Foot Mouth" treated?

Answer 27

SYMPTOMATIC - Magic mouthwash (mylanta, benadryl, & viscous lidocaine)

Question 28

What is Kawasaki Disease "Mucocutaneous LN Syndrome"? What's it characterized by?

Answer 28

Acute febrille illness of early childhood characterized by vasculitis of the medium-sized arteries

Question 29

T/F: Kawasaki is typically self-limiting

Answer 29

True

Question 30

What're S&S of Kawasaki?

Answer 30

- Fever - Bilateral nonexudative conjunctivitis - Erythema of lips & oral mucosa + dry/cracked lips - Rash - Edema of hands/feet - Cervical LAD - +/- Peeling

Question 31

Complications of Kawasaki?

Answer 31

- Coronary artery aneurysms - Depressed myocardial contractility & HF - MI - Arrhythmias - Peripheral arterial occlusion

Question 32

This is a leading cause of aquired heart disease in the US

Answer 32

Kawasaki Disease

Question 33

When is Kawasaki m/c? Who is typically affected?

Answer 33

- M/C in winter & spring - Kids 5/yo, M >F

Question 34

How is Kawasaki Disease treated?

Answer 34

IVIG & Aspirin

Question 35

What is the diagnostic criteria for Kawasaki. disease?

Answer 35

Presence of fever for at least 5 days + at least 4/5 of the following criteria: 1. B/L bulbar conjunctival injection 2. Oral mucous membrane changes 3. Peripheral extremity changes 4. Polymorphous rash 5. Cervical LAD