II. Causes: Common Systemic Conditions
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Roseola (Human Herpes Virus 6)
- Presents with high fever without significant focal findings, in a child who appears well
- Develops maculopapular central rash on trunk as the fever abates around day 4-5
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Pityriasis Rosea
- Onset with a herald patch (2-10 cm rose red border with fine scale and central clearing)
- Evolves with numerous small similar lesions, bilaterally symmetric in a christmas tree pattern
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Scarlet Fever
- Strep Pharyngitis associated rash with fine sandpaper-like Papules, and Sunburn-like blanching Macules
- Onset on the upper truck and generalizing within 24 hours
- As rash resolves, Desquamation of the palms and soles (as in Kawasaki Disease) as well as face
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Erythema Infectiosum (Fifth Disease, Parvovirus B19)
- Classic "slapped cheek" erythematous rash follows initial prodrome of low grade fever, Headache, Sore Throat
- Initial rash resolves after 2-4 days and is followed by reticular extremity rash for up to 6 weeks
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Atopic Dermatitis
- Pruritic Eczematous Dermatitis with onset in infancy (often in those with allergies and Asthma)
- Involves extensor surfaces and face in young children, and the flexor surfaces in older children
III. Causes: Common Localized Skin Infections
- See Skin Infection
- See Insect Bite
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Impetigo
- Self limited staph aureus (and less commonly strep) Skin Infection in areas of local Trauma (e.g. scratching)
- NonBullous Impetigo evolves from vessicles to honey colored crust on erythematous base over face, extremities
- Bullous Impetigo is a staph toxin mediated reaction presenting with bullae in the intertiginous areas
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Molluscum Contagiosum
- Small, clustered umbilicated flesh colored Papules that may persist for up to 2-4 years without treatment
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Tinea Infection
- See Fungal Skin Infection (characteristics vary by site)