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 as I see it 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 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 use to fit into this category but now they’re so rare most young physicians have never seen a case of it.) Nevertheless, there are other rash-associated conditions such as hand-foot-mouth disease, scarlet fever, pityriasis rosea, and shingles that you can easily master and 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.)   Click here to watch a video demonstrating a shingles rash.   Click here to watch a video demonstrating strep.   ...
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