Dermatitis can be primary, or secondary to scratching. Maculopapular rash pictures, causes, treatment, definition. Evaluating the febrile patient with a rash american family. Rashes can be categorized as maculopapular centrally and peripherally distributed, petechial. Mar 15, 2010 however, unless the diagnosis is obvious, it is usually more productive to start with a differential diagnosis that includes all reasonable possibilities. The rash starts to disappear from the face, and residual brown skin pigmentation may appear in. The differential diagnosis includes drug rash, pityriasis rosea, viral exanthem, infectious mononucleosis, tinea corporis, granuloma annulare, condylomata accuminata, and guttate psoriasis.
Nov 09, 2018 diaper rash, or diaper dermatitis, is a general term describing any of a number of inflammatory skin conditions that can occur in the diaper area. Maculopapular rash may be mistakenly called macule, papule, patch, nodule, plaque, vesicle, or pustule. If the clinical diagnosis of an itchy skin problem is uncertain, consider performing the following tests. To differentiate these skin lesions from each other, here are the pictures of each.
May 10, 2018 a maculopapular rash causes both flat and raised lesions on the skin. However, unless the diagnosis is obvious, it is usually more productive to start with a differential diagnosis that includes all reasonable possibilities. Combining the two terms, a maculopapular rash is as a smooth skin rash or redness covered by elevated bumps 1, 2, 3. An acute or chronic itchy rash is most often due to dermatitis eczema. The most common type of rash was determined as maculopapular and the most frequent 5 diseases were measles, drug reactions, chickenpox, asd and rickettsial infection. These disorders should be considered in the differential diagnosis. The patient with an acute maculopapular rash presents a diagnostic challenge to the clinician.
Wellappearing children without systemic symptoms or signs are unlikely to have a dangerous disorder. Maculopapular rash symptoms,pictures,causes,diagnosis. Approach to a the child with a fever and rash learn. Maculopapular rash pictures, causes, diagnosis 2020. Common noninfectious causes of macular and papular exanthems are listed in table 712. The differential diagnosis includes other maculopapular exanthems, such as measles, roseola, parvovirus b19 infection and drug eruptions. May 05, 2020 the differential diagnosis includes other maculopapular exanthems, such as measles, roseola, parvovirus b19 infection and drug eruptions. Oct 23, 2008 differential diagnosis in dermatology this website is for medical practitioners seeking a method to diagnose a skin rash. It is during the history phase that the doctor can tell whether the patient has maculopapular rash or not. Malar rash is a sign of sle systemic lupus erythematosis there are other other autoimmune diseases which can also have this rash. The differential diagnosis of membranous glomerulopathy and a rash includes systemic diseases systemic lupus erythematosus, sjogren syndrome, and sarcoidosis, infections hepatitis b and c virus, human immunodeficiency virus hiv, syphilis, schistosomiasis, and filariasis, malignancies carcinoma, leukemia. Tests are not usually necessary if the cause has been identified and stopped, the rash is mild and the patient is well.
The differential diagnosis for febrile patients with a rash is extensive. They are characterized by a diffuse and symmetric eruption of erythematous macules or small papules occurring approximately one week or, in previously sensitized individuals, as early as one or two days after the initiation of drug. Clinical features and etiology of adult patients with fever. In addition to nephrotic syndrome, our patient presented with a maculopapular rash. Nov 08, 2012 to conclude, adult patients with fever and rash had a wide differential diagnosis. Maculopapular rash pictures, causes, hiv, treatment. Although the differential diagnosis is very broad, adequate history and physical examination can help the clinician narrow down a list of more probable etiologies. After one to six weeks, the rash resolves but may reappear with sun exposure, heat, or stress. Common skin rashes in children american family physician.
You may experience a lowgrade fever and muscle pain. In the case of epsteinbarr mononucleosis virus, the administration of an antibiotic classically ampicillin can lead to a florid maculopapular rash. Allergic reactions to a drug may be the cause if the maculopapular rash develops four to 12 days after taking a medication. If the itch is generalised and no primary skin rash observed, check blood count, iron studies. The doctor will first go through the history of the patient and give a physical exam. Although many symptoms overlap, there are identifiable factors for each disease. The most distinctive feature of a maculopapular rash is the pattern of macules and papules.
Sandpaper rash differential what does the doctor say. The associated symptoms and signs help identify patients with a serious disorder and often suggest the diagnosis see table. Maculopapular rash differential diagnosis health for you. Gonococcemia might be the cause if it is accompanied with headache and confusion. He had conjunctivitis and log in using your username and password. The term maculopapular rash typically implies an acute and generalized eruption. Fever and rash university of massachusetts medical school. Differential diagnosis of a palmar and plantar rash the bmj. Sep 19, 20 a 35 year old man presented with a five day history of fever, cough, rash, and sore throat. This is also aimed for a differential diagnosis and for confirming the viral agent. A macule is a small, flat, red area of discoloration, and a papule is a small, red, raised lesion. Approach to a the child with a fever and rash learn pediatrics. Febrile illness with skin rashes pubmed central pmc.
The differential diagnosis of membranous glomerulopathy and a rash includes systemic diseases systemic lupus erythematosus, sjogren syndrome, and sarcoidosis, infections hepatitis b and c virus, human immunode. The term maculopapular rash is a general term assigned to all types of rashes with bumps on them. Diaper rash, or diaper dermatitis, is a general term describing any of a number of inflammatory skin conditions that can occur in the diaper area. Undressing the patient to fully examine the trunk and the extremities. When macules are 1 cm, the appropriate term is patch. In the second stage of the disease process, pink patches and macules may develop in a lacy, reticular pattern, most often on the extremities.
Review of systems for sle photosensitivity, malar or discoid rash, cytopenias, renal disease, etc. Evaluating the febrile patient with a rash american. The patient has to tell about past infections, and what had happened when the rash began. Maculopapular rash pictures, causes, treatment, diagnosis.
Differential diagnosis of the malar rash includes other autoimmune diseases, infectious causes, vitamin deficiencies, and some chromosomal disorders. To conclude, adult patients with fever and rash had a wide differential diagnosis. Epsteinbarr virus ebv infectious mononucleosis mono. In part i of this twopart article, tables listing common, uncommon, and rare causes of generalized rash are presented to help generate an inclusive differential diagnosis. Sign in with your personal account to earn and claim cme credits through visualdx. Sep 20, 2018 nonpruritic maculopapular rashes may be caused by a wide variety of infectious and noninfectious disorders. Aug 15, 2000 the rash begins as an erythematous maculopapular eruption that rapidly evolves to a vesicular rash. A maculopapular rash is a marker for many diseases, allergic reactions, and infections. The differential diagnosis this presentation fits within a diagnostic territory of an autoimmune disorder, a systemic inflammatory disorder, malignancy, and an infection. Clinical features and etiology of adult patients with.
The causes of a maculopapular rash can be an allergy, an infection, or a response to taking a new type of medication. Measles appears as a diffuse macular rash at the outset, followed by a rash with a papular morphology, and gradually develops into a morbilliform, or typical systemic maculopapular rash. The treatment for maculopapular rash is primarily symptomatic. The differential diagnoses of rash and fever depend largely on the distribution of the rash. Differential diagnosis in dermatology this website is for medical practitioners seeking a method to diagnose a skin rash. Maculopapular rash is a compound word composed of the words macule and papule. In order to get rid of the rash, the underlying cause should be treated first. Reactions to medications can take up to seven or eight days to show symptoms. Sep 30, 2015 measles appears as a diffuse macular rash at the outset, followed by a rash with a papular morphology, and gradually develops into a morbilliform, or typical systemic maculopapular rash. A macule is a flat blemish or discoloration that measures less than 1 cm. Diaper rash differential diagnoses medscape reference. A maculopapular rash is a type of rash characterized by a flat, red area on the skin that is covered with small confluent bumps. Maculopapular rashes are differentiated by the distribution of the rash and systemic toxicity. Evaluation of maculopapular rash differential diagnosis.
Maculopapular rash can also be diagnosed basing on the presentation of symptoms. The diagnosis of rubella can be made with igm antibody. Two to six weeks after exposure to the virus, people with hiv may break out in a maculopapular rash on the upper part of their bodies as a result of developing acute retroviral syndrome, the flulike symptoms that newly infected individuals sometimes exhibit. Differential diagnosis includes measles, rubella, scarlet fever, nonspecific toxic erythema associated with infection, kawasaki disease, connective tissue disease and acute graftversushost disease.
Credits can be earned by building a differential or looking up a diagnosis. If the rash does not resolve spontaneously, skin biopsy and blood testing e. Things to consider in these patients are drug reactions, pityriasis, scabies, eczema and psoriasis. Rashes that are directly or indirectly caused by the wearing of diapers. This patient presented with secondary syphilis in the form of nonitchy psoriasiform plaques on the palms. The patient was pyrexial, tachycardic, and hypoxic on admission. Skin biopsy is done in cases where severe cases takes place. Jan, 2020 in addition to scarlet fever and the german measles, maculopapular rashes are associated with hiv, the virus that causes aids. The appearance of the rash typically narrows the differential diagnosis. In addition to scarlet fever and the german measles, maculopapular rashes are associated with hiv, the virus that causes aids. The differential diagnosis of itchy skin dermnet nz. Diseases that present with fever and rash are usually classified according to the morphology of the primary lesion.
A papule is as elevated lesion measuring less than 1 cm. Doctors give trusted, helpful answers on causes, diagnosis, symptoms, treatment, and more. Unfortunately, maculopapular rashes are generalized, offering little opportunity to narrow differential diagnostic possibilities. When this appears on the face, it can either be caused by measles or other viral infections. Rash in infants and young children pediatrics msd manual. We briefly describe a 36yearold man who presented with acute pancreatitis and a maculopapular rash. This category includes dermatoses, such as irritant contact.
A maculopapular rash causes both flat and raised lesions on the skin. Patients with acute generalized maculopapular rashes and no systemic symptoms are often treated symptomatically without a definitive diagnosis. Mar 21, 2017 a maculopapular rash is a marker for many diseases, allergic reactions, and infections. It is important for physicians to be diligent, as the differential diagnosis can include. The term maculopapular is nonspecific, as many eruptions have a primary morphology of macules or papules, and the term may be misused to indicate any rash. Then one needs to deeply inspect the site and extent of the rashes and see if they are itchy, painful or irritating. Finally, the differential diagnosis of acute pancreatitis in combination with a maculopapular rash includes systemic lupus erythematosus 22, marburg virus 23, west pancreas. List of 25 causes of maculopapular rash, alternative diagnoses, rare causes, misdiagnoses, patient stories, and much more. Aprof amanda oakley, dermatologist, hamilton, new zealand, february 2016. Nephrotic syndrome and a maculopapular rash american.
General presentation children frequently present at the physicians office or emergency room with a fever and rash. Malar rash characterized by symmetrical fixed erythematous maculopapular rash with slight scale occurring over the bilateral cheeks and nose, with relative sparing of the nasolabial folds. Maculopapular rash differential diagnosis one can diagnose maculopapular rash by first taking into account past illness or diseases. Common cutaneous complications in hivpositive patients. Nonpruritic maculopapular rashes may be caused by a wide variety of infectious and noninfectious disorders. If the itch is generalised and no primary skin rash observed, check blood count, iron studies, renal, liver and thyroid function, chest xray. The rash starts to disappear from the face, and residual brown skin pigmentation may appear in areas where the rash has faded. Morbilliform drug eruptions exanthematous drug eruption. Exanthematous drug eruption, also called morbilliform or maculopapular drug eruption, is the most common type of drug hypersensitivity reaction. Maculopapular rash pictures, causes, hiv, treatment, diagnosis. Touch the skin with a gloved hand to determine if the lesions are flat or raised. These disorders can be conceptually divided into 3 categories. What you should be alert for in the history the onset of a morbilliform eruption mde. Patients with acute generalized maculopapular rashes and no systemic symptoms are often.
Patients with centrally distributed rashes who appear toxic and febrile have a wide differential diagnosis. Maculopapular rash symptom checker right diagnosis. Differential diagnosis of maculopapular rash maculopapular rash may be mistakenly called macule, papule, patch, nodule, plaque, vesicle, or pustule. A 35 year old man presented with a five day history of fever, cough, rash, and sore throat. Evaluation of maculopapular rash differential diagnosis of. Blanching erythematous maculopapular rash begins in head and neck a spreads centrifugally to trunk and exrtremities.