Diagnosis: Exanthem
Scarlet fever sandpaper rash on neck and trunk of 8-year old with fever, confirmed strep throat and strawberry tongue.. Clinical photograph sourced from Wikimedia Commons (CC BY-SA 4.0). Attribution: Whispyhistory.
Typically symmetric, maculopapular eruption starting centrally and spreading peripherally. Specific patterns: cephalocaudal spread (measles), slapped-cheek (parvovirus B19), lacy reticular (fifth disease), blueberry muffin (congenital infections).
Prodromal symptoms (fever, malaise, URI symptoms), vaccination history, sick contacts, travel history, medication changes, immunocompromised status. Mucosal involvement (Koplik spots in measles).
Usually self-limited. Supportive care with antipyretics, antihistamines for pruritus. Specific antivirals when indicated (acyclovir for varicella in immunocompromised). Immunoglobulin for measles in susceptible patients.
Morbilliform drug eruption, Viral exanthem, Scarlet fever, Secondary syphilis, Acute HIV, Kawasaki disease
The six classic childhood exanthems should be recognized clinically. Drug eruptions must be excluded — timing relative to new medications is key. Mucosal involvement may suggest more serious diagnoses.
Tags: exanthem, viral, maculopapular, infectious