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BY
MAYSA AMER

   

 Rash
‡ A rash may be an exanthum or an enanthum.
‡ ?

‡ O
   macules are areas of skin
discoloration which are seen but not felt as they
are not raised over the skin surface.They may
be erythematus, Purpuric, pigmented or
depigmented
‡ 

 is a very large macule 15-20 cm in
diameter.
‡ Papules: are palpable solid elevations of the
skin of up to 5 mm in diameter.
‡   are lare papules.
‡ Maculopapular rash: consists of both macules
and papules.
‡ Vesicle: visible accumulation of fluid within or
beneath the epidermis. Vesicles are small ( less
than 0.5 cm in diameter)
‡ Bullae : big vesicles more than 0.5 cm in
diameter.
‡ Pustule: a vesicle containing pus.
‡ Crust or scale: consist of dried serum and other
exudates.
‡ Erosion: loss of epidermis which heals without
scarring, it commonly follows a burn.
‡ Excoriation : loss of skin surface produced by
scratching.
‡ Scale: a flat plaque or flake of stratum corneum.
‡ ?
 :( bruise) an area of cutaneous and
subcutaneous hemorrhage causing a palpable
lump.
‡ Hematoma : a fluctuant collection of blood.
‡ Purpura ( petich): extravasations of RBCs in the
skin. Unlike erythema, purpura can't be
blanched by pressure. Purpura may be punctate
from capillary hemorrhage or may form large
macules according to the extent of hemorrhage
and size of vessels involved.
 Enanthum
‡ An Enanthum is a rash over mucus membranes.
‡ An enanath may be a hemorrhagic enanthum as
seen over the mucus membrane of the mouth
especially over the soft palate in cases of
streptococcal tonsillopharyngitis.
‡ Or the enanthum may be erythematus spots as
seen in the catarrhal phase of measles.
‡ Enanthem in cases of rubella are in the form of
discrete rose spots on the soft palate may
coalesce into blotches.
 |
ECT|OUS D|SEASES CAUS| 
MACULOPAPULAR RASH
‡ MEASLES (RUBEOLA)
‡ ERMA MEASLES (RUBELLA)
‡ SCARLET
EVER
‡ ROSEOLA |
A TUM
‡ ERYTHEMA |
ECT|OSUM
‡ EBV(|
ECT|OUSE MO O UCLEOS|S)
‡ E TEROV|RUS |
ECT|O S W|TH
RASH
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 Clinical Picture
‡ Prodrome:
ever+
3C(coryza,cough,conjunctivitis) +
Enanthem+ koplik`s spots

‡ Rash ( Exanthem),
ever

‡
ading of Rash & Resolution / Or

Complications
‡ ?


# ‡ 



‡ Transmission: person ‡ Live attenuated

to person by vaccine, combined
respiratory droplets. with mumps and
Malnutrition rubella (MMR)
contributes to high ‡ Administration:
mortality. between 12 ± 18
months.
 Measels

‡ V 

  
‡ Respiratory complications (otitis media,
pneumonia, bronchopneumonia, activation of
latent T.B)
‡ eurological complications (encephalitis, aseptic
meningitis, SSPE)
‡ Skin and mucus membrane (hemorrhagic rash,
bleeding from mm, purpura)
‡ Digestive tract (diarrhea with vomiting, ulcerative
stomatitis)
‡ |mpaired immunity.
 O

 
    

O
 
 

Prevention
 Rubella
‡ Cause: rubella virus.
‡ Types of infection :droplet infection, vertical
transmission.
‡ |P: 2-3weeks
‡ |nfectivity: 7 days before till 7 days after rash disappears,
‡ Prodrom: Catarrh, L. (enlarged tender retroauricular,
post. Cervical, and post occipital lymph nodes appear 1
day before rash and remains for 1 week or more)

‡ Enanthem (discrete rose spots on the soft palate may

coalesce into blotches)

‡ Rash : 3 days
 


‡ |ncubation period: 14± 21 days

irst day:  
 


  
 
 





 
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‡ Complications : Encephalitis , thrombocytopenic

purpura and polyarthritis are reported complications
RUBELLA
 Congenital Rubella
‡ 2 ( blue berry
muffin rash
representing dermal
erythropoesis)
‡ #  

‡ #$% (PDA)
‡ 
‡   
 
‡ O


 &
    
 Congenital Rubella

‡ Other systems: Lungs, Blood, Skin, Liver

& spleen.
wCongenital rubella syndrome: serological testing for
specific |gM. Maternal |gM does not cross the placenta
so detection of specific |gM is diagnostic of
intrauterine infection
 Control

‡ Attenuated live vaccine (MMR)

‡ Seroconversion occurs in over 95%
‡ Protection persists for more than 20 years
‡ Administration in pregnancy is contra-
indicated
‡ Pregnancy should be avoided for a month
following vaccination
 à%&? '?
?
‡ Definition
‡ Etiology
‡ |mportance
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Recommended
‡ Penicillin (best). ‡ Amoxycillin.
± One long acting
penicillin. ‡ Cephalosporines
± Daily procaine ‡ ? 

penicillin
± Oral penicillin.
  


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  ,
 

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 Roseola |nfantum
‡ The disease is common between 6 months and 3 years

‡ Sudden onset of high fever lasts for 3-5 days, and is

accompanied by malaise, irritability and even
convulsions.
ever then drops abruptly. The temperature
may remain subnormal for few hrs during which rash
appears.

‡ Rash is faintly erythematus ( rose colored), macular or

maculopapular, very similar to rubella)
 



ifth Disease,
Erythema |nfectiosum
‡ Parvovirus B19
‡
ever, malaise & headache may precede rash by up to
10 days
‡ ³Slapped cheeksë and within 4 days this rash disappears
and another maculopapular erythematus rash appears
on the extensor surfaces of the extremities and spreads
in 2-3 days to involve the flexor surfaces and the trunk ,
central clearing of the macular lesions occur promptly
giving a typical lace- like or reticular appearance
‡ o longer infectious once rash develops
‡ Virus may also cause polyarthropathy syndrome,
aplastic crisis, or hydrops fetalis
ERYTHEMA |
ECT|OUSUM
 |
ECT|OUS MO O UCLEOS|S
‡
ever
‡ Exudative tonsillitis
‡ eneralized lymphadenopathy
‡ Splenomegaly hepatomegaly
‡ Rash: 20% after Ampicillin: 80-90%
‡ Other manifestations ( eneral ±
Hematologic)
Other viral diseases
associated with
Maculopapular rash
Echo virus infection with rash
 |
ECT|OUS D|SEASES W|TH
VES|CULAR ERUPT|O
‡ VAR|CELLA / ZOSTER |
ECT|O S

‡ HERES S|MPLEX

‡ HERPA | A
 Varicella Zoster |nfections
Virus

on immune
patient
Varicella Zoster |nfections



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Clinical Types:
‡ Cold Sore.
‡ 1ry Herpetic ingivostomatitis
‡ Herpetic Skin lesions
‡ Herpetic Encepahalitis
‡ Disseminated Herpes
 ? 

  "

)

 
V 

‡ Two groups: A and B

‡ roup A:
± Herpangina (vesicular pharyngitis)
± Hand ±
oot ± and ± Mouth disease
± Acute hemorrhagic conjunctivitis

‡ roup B:
± Pleurodynia (epidemic myalgia)
± Myocarditis
± Meningoencephalitis
Hand
oot & mouth Disease


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‡ Etiology: Mumps Virus
‡ |P: 2-3 wks (18Ds)
‡ |nfection: Direct Contact
‡ |nfectivity 1day before and 9 days after
start of parotitis.
‡ Clinical Picture:
± Prodrome
± Salivary land swelling
 Complications
‡ Other lands:
± Pancreatitis
± onads:
± Epidedymo-Orchitis
± Oopheritis
± Thyroiditis
‡ Other organs:
± Encephalitis- Meningo/
± Myocardidits
± ephritis
± Arthritis
± Purpura
 Prevention & treatment
‡ Vaccine

‡ Treatment: Supportive
|mptigo