In Kawasaki disease, desquamation and denudation of skin from fingers and toes occur at
**Core Concept**
Kawasaki disease is an acute, febrile vasculitis of medium-sized arteries, primarily affecting children. It involves inflammation of the blood vessels, leading to symptoms such as rash, conjunctivitis, and desquamation of the skin.
**Why the Correct Answer is Right**
Desquamation and denudation of skin from fingers and toes occur during the subacute phase of Kawasaki disease, typically around 2-3 weeks after the onset of fever. This process is thought to be due to the re-epithelialization of the skin after the initial inflammatory response. The denudation of skin from fingers and toes is a classic sign of Kawasaki disease and is often used as a diagnostic criterion.
**Why Each Wrong Option is Incorrect**
* **Option A:** This option is incorrect because the timing of desquamation and denudation is specific to the subacute phase of the disease, and it does not occur immediately after the onset of fever.
* **Option B:** This option is incorrect because while peeling of the skin can occur in Kawasaki disease, it is not a specific or diagnostic feature of the condition.
* **Option C:** This option is incorrect because the process of desquamation and denudation is a specific manifestation of Kawasaki disease and does not occur in other conditions.
**Clinical Pearl / High-Yield Fact**
The desquamation of skin from fingers and toes in Kawasaki disease is a classic sign of the subacute phase and should prompt clinicians to consider this diagnosis in children with fever and rash.
**Correct Answer:** D. 2-3 weeks.