How I Break Down Pediatric Rashes

More than once, I’ve heard colleagues and residents make the statement, “I’m no good at pediatric rashes.” The truth is that there is usually a large waste basket of “nonspecific viral exanthems” that are easy to bring to closure in your conversation with parents, and then there are similar-appearing rashes associated with drug reactions.   Then there are the targeted lesions, which include acute annular urticaria or urticaria multiforme, erythema multiforme minor, and serum sickness-like rashes that are frequently confused for each other.   My simplistic approach continues by acknowledging that there are rare rashes like id reactions, Gianotti-Crosti rashes, fixed drug reactions, and others that may require an iPhone video or picture consultation with your dermatologist.   Finally, there is the subset of relatively easy rashes that are common and specific in appearance. (Chicken pox or varicella used to fit into this category, but now they’re so rare that most young physicians have never seen a case.) Nevertheless, other rash-associated conditions include hand-foot-mouth disease, scarlet fever, pityriasis rosea, and shingles that are easy to master, and you won’t forget after seeing one or two cases. This month’s videos demonstrate three of those relatively common pediatric rashes (scarlet fever, pityriasis rosea, and shingles.)   EPs are frequently heard to say they aren’t good at diagnosing pediatric rashes, but this video will help iden...
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