Maculopapular rashs are seen in all except:
Correct Answer: Scarlet fever
Description: Ans: A (Scarlet...) Scarlet fever cause confluent desquamative erythemas- Harrison 19th/130Maculopapular Viral Exanthems Neena Khanna 4th/282# "MeasIes(Rubeola): maculopapular confluent rash which evolves in a cranio-caudal fashion & fades with scaling""German measles:erythema tous discrete macular rash "Table (Harrison 19th/128,18thf 149-51): Centrally Distributed Maculopapular EruptionsDiseaseDescriptionRubeola (measles, first disease)Discrete lesions that become confluent as rash spreads from hairline downward, sparing palms and soles: lasts >3 days; Koplik's spotsRubella (German measles, third disease)Spreads from hairline downward, clearing as it spreads; Forschbeimer spotsErythema infectiosum (fifth disease)Brightred "slapped-cbeeks" appearance followed by lacy reticular rash that waxes and wanes over 3 weeks; rarely, papular-purpuric "gloves-and- socks" syndrome on hands and feetExanthem subitum (roseola, sixth disease)Diffuse maculopapular eruption over trunk and neck; resolves within 2 daysInfectious mononucleosisDiffuse maculopapular eruption (5% of cases; 90% if ampiciUin is given); urticaria, petechiae in some cases; periorbita] edema (50%); palatal petechiae (25%)Epidemic typhusMaculopapular eruption appearing in axillae, spreading to trunk and later to extremities; usually spares face, palms, soles; evolves from blanchable macules to confluent eruption with petechiae; rash evanescent in recrudescent typhus (Briil-Zinsser disease)Endemic (murine) typhusMaculopapular eruption, usually sparing palms, solesScrub typhusDiffuse macular rash starting on trunk; eschar at site of mite biteRickettsial spotted feversEschar common at bite site; maculopapular (rarely, vesicular and petechial) eruption on proximal extremities, spreading to trunk and faceHuman monocytotropic ehrlichiosis"Maculopapular eruption (40% of cases), involves trunk and extremities; may be petechialLeptospirosisMaculopapular eruption; conjunctivitis; scleral hemorrhage in some casesLyme diseasePapule expanding to erythematous annular lesion with central clearing (erythema migrans; average diameter, 15 cm), sometimes with concentric rings, sometimes with indurated or vesicular center; multiple secondary erythema migrans lesions in some casesTyphoid feverTransient, btanchable erythematous macules and papules, 2-4 mm, usually on trunk (rose spots)Dengue feverRash in 50% of cases; initially diffuse flushing; midway through illness, onset of maculopapular rash, which begins on trunk and spreads centrifugaily to extremities and face; pruritus, hyperesthesia in some cases; after defervescence, petechiae on extremities in some cases' Varicella(Chickeopox): A characteristic feature of rash is its peomarphism i.e, alt stage of rash (papules, vesicles & crusts) may be seen simultaneously at one time, in the same area. Temperature rise with each fresh crop of rash"- Park 23stf 144"Exanthem subitum (roseola) is caused by human herpesvirus 6 and is most common among children <3 years of age . As in erythema infectiosum, the rash usually appears after fever has subsided. It consists of 2- to 3-mm rose-p/nk macules and papules that rarely coalesce, which occur initially on the trunk and sometimes on the extremities (sparing the face) and fade within 2 days"- Harrison 18thf 148"Rubella (German measles) also spreads from the hairline downward; unlike that of measles, however, the rash of rubella tends to clear from originally affected areas as it migrates, and it may be pruritic. Forehheimer spots (palatal petechiae) may develop but are nonspecific because they also develop in mononucleosis and scarlet fever"- Harrison 18th/148
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