II. Causes: Common Systemic Conditions

  1. Roseola (Human Herpes Virus 6)
    1. Presents with high fever without significant focal findings, in a child who appears well
    2. Develops maculopapular central rash on trunk as the fever abates around day 4-5
  2. Pityriasis Rosea
    1. Onset with a herald patch (2-10 cm rose red border with fine scale and central clearing)
    2. Evolves with numerous small similar lesions, bilaterally symmetric in a christmas tree pattern
  3. Scarlet Fever
    1. Strep Pharyngitis associated rash with fine sandpaper-like Papules, and Sunburn-like blanching Macules
    2. Onset on the upper truck and generalizing within 24 hours
    3. As rash resolves, Desquamation of the palms and soles (as in Kawasaki Disease) as well as face
  4. Erythema Infectiosum (Fifth Disease, Parvovirus B19)
    1. Classic "slapped cheek" erythematous rash follows initial prodrome of low grade fever, Headache, Sore Throat
    2. Initial rash resolves after 2-4 days and is followed by reticular extremity rash for up to 6 weeks
  5. Atopic Dermatitis
    1. Pruritic Eczematous Dermatitis with onset in infancy (often in those with allergies and Asthma)
    2. Involves extensor surfaces and face in young children, and the flexor surfaces in older children

III. Causes: Common Localized Skin Infections

  1. See Skin Infection
  2. See Insect Bite
  3. Impetigo
    1. Self limited staph aureus (and less commonly strep) Skin Infection in areas of local Trauma (e.g. scratching)
    2. NonBullous Impetigo evolves from vessicles to honey colored crust on erythematous base over face, extremities
    3. Bullous Impetigo is a staph toxin mediated reaction presenting with bullae in the intertiginous areas
  4. Molluscum Contagiosum
    1. Small, clustered umbilicated flesh colored Papules that may persist for up to 2-4 years without treatment
  5. Tinea Infection
    1. See Fungal Skin Infection (characteristics vary by site)

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