Paediatric rashes.
This child has a 2 day history of an URTI, headache, fever and malaise. Now this rash turns up. What is it?
Slapped cheek, also known as 5th disease is caused by parvovirus B19. It is mildly contagious (respiratory secretions). No treatment required however it can be a concern if you are pregnant with potential complications for the fetus.
This 10yr old has a palpable non blanching rash over their legs and buttocks. A urine analysis shows some protein. What do they have?
HSP usually occurs post viral with palpable purpura often painful ankles and/or wrists. May get scrotal oedema (in males duh). About 50 % get some abdominal pain and a variable amount of IgA nephropathy (therefore protein in urine). ARENA mnemonic (Abdominal pain Renal disease Edema Non blanching rash Arthritis.)
This young girl presents with a fever, sore throat, red tongue, a rough rash and slight peeling of the palms. What does she have?
Caused by Strep pyogenes (Grp A). Strawberry tongue first then sandpaper rash then desquamation hands, feet.Treat with Penicillin, Analgesia, Rest.
This girls rash was caused by the drug Lamotrigine. What did she suffer?
Steven Johnson Syndrome (also known as Erythema multiforme major) has multiple potential precipitants. Infections (Mycoplasma, viral), Drugs (Allopurinol, Sulphur and many others), Malignancy. Still 50% are idiopathic. Widespread mucosal and dermal sloughing. Treatment is generally fastidious supportive care.
The photo is of 2 brothers who got this rash. The one on our right is vaccinated. What is the rash? The lower picture shows the long history of the anti vax movement.
Small pox was called small to differentiate it from the great pox which was Syphilis. It is thought the earliest record of the pustules on the face was on the body of Pharaoh Ramses V who died in 1157 BC. Vaccination eradicated it because vaccination produced lasting immunity, there was no animal reservoirs of infection and the virus was too fragile to last long outside the human body.
This infant had a high fever for a few days and was miserable. This morning this blanching rash came out firstly on his trunk. The childs fever has settled. What is the rash?
A classic story of a very common viral infection. It is caused by one of the Herpes viruses and treatment is supportive. The Royal Childrens Hospital Melbourne is a good---go to--web site if you need reminding of paediatric rashes.
This child has these non itchy lesions along with a fever and sore throat. What is it?
Well there is a picture of a hand, foot and mouth so probably a hint. It is caused by a Coxsackie A16 virus mainly. Highly contagious. Keep home around 7 to 10 days. Xylocaine viscus a couple of times a day can help with the painful mouth lesions.
What rash does this brief video show?
Staph scalded skin syndrome is caused by the Staph exotoxin. The primary Staph infection is usually around the mouth or nose. Treatment is supportive along with IV Flucloxacillin (Vancomycin if MRSA suspected). No mucosal involvement. Can look much redder and angrier than this case.
A 12mth old child presents with a fever and this rash which developed over a couple of days. What is it?
This is a primary HSV (Herpes Simplex) infection. The vesicles burn and itch. Often need IV antivirals. They heal in about 10 days. Isolate the child.
13Yr old boy with Covid has a multi system inflammatory disorder (fever, conjunctivitis, abdominal pain). This rash appeared. What is it?
Characteristic target lesions. Covid---yet another potential cause of Erythema Multiforme. (Image from BMJ article http://dx.doi.org/10.1136/bcr-2020-236986)