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Rash, Pediatric, Emergency Medicine

Bruce Webster Reviewed 06/2017
 


Basics

Description

  • Lesion morphology:

    • Macule:

      • Localized nonpalpable changes in skin color

      • Purpura or petechiae (nonblanching with pressure)

    • Maculopapule:

      • Slightly elevated lesions with localized changes in ...

Diagnosis

Signs and Symptoms

  • Fever (consider infectious exanthemas)

  • Pruritus

  • Joint pain

  • Abdominal pain

  • Heart murmur

History

Obtain a detailed history: 
  • Age group: Conditions, distribution, and appearance may ...

Treatment

Pre-Hospital

Field management is indicated when there are signs of systemic instability: 
  • Airway management using precautions to avoid exposure to respiratory secretions; IV access

  • Identify ras...

Follow-Up

Disposition

Admission Criteria

  • Hospital admission is determined by the underlying disorder.

  • Other illnesses associated with systemic illness or potential deterioration, SSS, rubeola, and varice...

Pearls and Pitfalls

  • Note where rash 1st appeared and how it is spreading.

  • Note associated signs and symptoms. They are often key for critical illness.

  • Keep meningococcemia in mind in any rash with fever...

Additional Reading

  • Dermatology atlas: http://www.dermatlas.org/.

  • Ely  JW, Seabury Stone  M. The generalized rash: Part I and part II. Am Fam Physician.  2010;81:726–739.

  • Fölster-Holst  R, Kreth,  H...

Codes

ICD9

  • 691.0 Diaper or napkin rash

  • 782.1 Rash and other nonspecific skin eruption

  • 782.7 Spontaneous ecchymoses

  • 287.2 Other nonthrombocytopenic purpuras

  • 693.0 Dermatitis due to drugs and medicines taken...

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