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==Petechial==
==Background==
{{Skin anatomy background images}}
{{Rash red flags}}
{{Primary derm lesions names}}
 
==Differential Diagnosis by Rash Type==
===[[petechiae|Petechial]]===
*Infectious
*Infectious
**[[Dengue fever]]
**[[EBV]]
**[[Endocarditis]]
**[[Endocarditis]]
**[[Meningococcemia]]
**Enteric bacteria (e.g. [[e. coli]], [[shigella]])
**[[Enterovirus]]
**[[Epidemic typhus]]
**[[Gonococcemia]]
**[[Gonococcemia]]
**[[Gram negative bacteria]]
**[[Gram negative bacteria]]
**[[Enteric bacteria]]
**[[Hepatitis B]]
**[[Meningococcemia]]
**[[Rat bite fever]]
**[[RMSF]]
**[[RMSF]]
**[[Enterovirus]]
**[[Dengue Fever]]
**[[Hepatitis B]]
**[[Rubella]]
**[[Rubella]]
**[[EBV]]
 
**[[Rat bite fever]]
**[[Epidemic typhus]]
*Noninfectious
*Noninfectious
**Allergy
**[[allergic reaction|Allergy]]
**[[Amyloidosis]]
**[[HSP]]
**Hypersensitivity [[vasculitis]]
**[[Lupus]]
**[[Rheumatic fever]]
**[[Scurvy]]
**[[Thrombocytopenia]]
**[[Thrombocytopenia]]
**[[Scurvy]]
**[[Lupus]]
**[[HSP]]
**[[Hypersensitivity vasculitis]]
**[[Rhumatic fever]]
**[[Amyloidosis]]


===Pediatric===
====Pediatric====
*Skin changes are often the most concerning finding in a pediatric fever
''Skin changes are often the most concerning finding in a pediatric fever''
====Differential====
*[[Meningitis (Peds)]]
*[[HSP]]
*[[HSP]]
*[[HUS]]
*[[ITP]]
*[[ITP]]
*[[Meningitis (Peds)]]
*[[Microangiopathic Hemolytic Anemia (MAHA)]]
*[[Microangiopathic Hemolytic Anemia (MAHA)]]
*[[TTP]]
*[[TTP]]
*[[HUS]]
====Workup====
*CBC
*Blood Cultures
*Basic Metabolic Panel (evaluating creatine)
*Chest Xray if pulmonary symptoms
*[[Lumbar Puncture]] depending on clinical findings and if not thrombocytopenic


==Maculopapular==
===Maculopapular===
*Infectious  
*Infectious
**[[Typhoid fever]]/[[typhus]]
**[[Adenovirus]]
**Secondary [[syphilis]]
**[[Arbovirus]]
**[[EBV]]
**[[Ehrlichiosis]]
**[[Enterovirus]]
**[[Fifths disease]]
**[[HSV 6]]
**[[Leptospirosis]]
**[[Lyme]]
**[[Lyme]]
**[[Meningococcemia]]
**[[Meningococcemia]]
**[[Mycoplasma]]
**[[Mycoplasma]]
**[[Parvovirus (B19)]]
**Primary [[HIV]]
**[[Psittacosis]]
**[[Psittacosis]]
**[[Rickettsia]]
**[[Rickettsia]]
**[[Leptospiroisis]]
**[[Rubella]]
**[[Ehrlichiosis]]
**[[Enterovirus]]
**[[Parvovirus (B19)]]
**[[5th Dz]]
**[[HSV 6]]
**[[Rubeola]]
**[[Rubeola]]
**[[Rubella]]
**Secondary [[syphilis]]
**[[Arbovirus]]
**[[EBV]]
**[[Adenovirus]]
**Primary [[HIV]]
**[[Streptobacillus moniliformis]]
**[[Streptobacillus moniliformis]]
**[[Typhoid fever]]/[[typhus]]
*Noninfectious
*Noninfectious
**Allergy
**[[Acrodermatitis enteropathica]]
**[[Serum Sickness]]
**[[Allergic reaction|Allergy]]
**[[Dermatomyositis]]
**[[Erythema marginatum]]
**[[Erythema multiforme]]
**[[Erythema multiforme]]
**[[Erythema marginatum]]
**[[Lupus]]
**[[Lupus]]
**[[Dermatomyositis]]
**[[Serum sickness]]
**[[Sweet's syndrome]]
**[[Sweet's syndrome]]
**[[Acroderm enteropathica]]


==Vesico-Bullous==
===[[Vesiculobullous rashes|Vesico-Bullous]]===
*Infectious
*Infectious
**[[Staph]]
**[[Enterovirus]]
**[[Fifths disease]]
**[[Folliculitis]] ([[Staph]], [[Candida]], [[Pseudomonas]])
**[[GC]]
**[[GC]]
**[[HIV]]
**[[HSV]]
**[[Parvovirus B19]]
**[[Rickettsia]]
**[[Rickettsia]]
**[[HSV]]
**[[Staph]]
**[[Varicella]]
**[[Varicella]]
**[[Vibrio vulnificans]]
**[[Vibrio vulnificans]]
**[[Folliculitis]] ([[Staph]], [[Candida]], [[Pseudomonas]])
 
**Enterovirus
**[[5th Dz]]
**[[Parvovirus B19]]
**[[HIV]]
*Noninfectious
*Noninfectious
**Allergy
**[[Allergic reaction|Allergy]]
**Plant dermatitis
**Eczema vaccinatum
**Eczema vaccinatum
**Erythema multiforme bullosum
**[[Erythema multiforme]] bullosum
**[[Poison Oak, Ivy, Sumac|Plant dermatitis]]


==Erythematous==
===Erythematous===
*Infectious
*Infectious
**[[Staph]]/[[strep]] ([[toxic shock]], [[scarlet fever]])
**[[Staph]]/[[strep]] ([[toxic shock syndrome|toxic shock]], [[scarlet fever]])
**[[Ehrlichiosis]]
**[[Ehrlichiosis]]
**[[Strep viridans]]
**[[Strep viridans]]
**[[C. haemolyticum]]
**[[corynebacterium|C. haemolyticum]]
**[[Kawasaki's]]
**[[Kawasaki's]]
**Enterovirus
**[[Enterovirus]]
 
*Noninfectious
*Noninfectious
**Allergy
**[[Allergic reaction|Allergy]]
**Vasodilation
**[[Eczema]]
**Eczema
**[[Lymphoma]]
**Pityriasis rubra
**[[Psoriasis]]
**[[Psoriasis]]
**Lymphoma
**Pityriasis rubra
**Sezary syndrome
**Sezary syndrome
**Vasodilation


==Urticarial==
===Urticarial===
*Infectious
*Infectious
**[[Adenovirus]]
**[[EBV]]
**[[Enterovirus]]
**[[Hep B]]
**[[HIV]]
**[[Loiasis]]
**[[Lyme]]
**[[Mycoplasma]]
**[[Mycoplasma]]
**[[Lyme]]
**[[Onchocerciasis]]
**Enterovirus
**[[Schistosomiasis]]
**[[HIV]]
**[[Hep B]]
**Adenovirus
**[[EBV]]
**[[Strongyloides]]
**[[Strongyloides]]
**[[Trichinosis]]
**[[Trichinosis]]
**[[Schistosomiasis]]
 
**[[Onchocerciasis]]
**[[Loiasis]]
*Noninfectious
*Noninfectious
**Allergy
**[[Allergic reaction|Allergy]]
**Vasculitis
**Idiopathic
**Malignancy
**Malignancy
**Idiopathic
**[[Vasculitis]]


==See Also==
==See Also==
*[[Rashes]]
*[[Rashes]]
*[[Fever]]


==References==
==References==
*Tarascon Adult Emergency Pocketbook
<references/>
 


[[Category:Derm]]
[[Category:Dermatology]]
[[Category:ID]]
[[Category:ID]]
[[Category:Symptoms]]

Latest revision as of 18:23, 30 July 2025

Background

Normal dermal anatomy.

Rash Red Flags[1]

Dermatology Nomenclature

Small lesions (<0.5cm)

Name Raised/Palpable Fluid-Filled Other Description Diagram
Macule No None flat, cirumscribed, colored Macule.png
Papule Yes None Solid Papule.png
Vesicle Yes Clear Vesicles (2).png
Pustule Yes Pus Leukocytes or keratin Pustules.png

Large lesions (>0.5cm)

Name Raised/Palpable Fluid-Filled Other Description Diagram
Patch No None Large macule (flat, colored) Patch.png
Plaque Yes None Superficially raised, circumscribed solid area Plaque.png
Nodule Yes None Distinct large papule Nodules.png.png
Bulla Yes Clear Large vesicle/blister or exposed epidermal layer Bulla.png
Wheal Yes Edema Firm and edema of dermis

Other

Ulcer, fissue, and erosion

Differential Diagnosis by Rash Type

Petechial

Pediatric

Skin changes are often the most concerning finding in a pediatric fever

Maculopapular

Vesico-Bullous

Erythematous

Urticarial

See Also

References

  1. ↑ Nguyen T and Freedman J. Dermatologic Emergencies: Diagnosing and Managing Life-Threatening Rashes. Emergency Medicine Practice. September 2002 volume 4 no 9.
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