after we discuss measles in last article ( click here to see ) we will continue our big topic about fever&rash in pediatric
this articles will include :
kawasaki syndrome
erythema multiforme
stevens-johonson syndrome
group A streptococci
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kawasaki syndrome :
the onset of kawasaki rash typically occurs after 3-5 days after fever onset , the rash has generalized distribution with morbilliform or scarlatiniform nature , in young infants it may be limited to diaper area
what are the facial feature of kawasaki disease ?
1-morbilliform rash
2- non suppurative conjunctivitis(congestion of bulbar conjunctiva )
3- red-chapped lips
what is the manifestation of kawasaki in fingers and hands ?
desquamation of fingers occur in kawasaki , also indurative edema of hand
what is the other name of kawasaki disease ?
muco-cutaneous lymph node syndrome
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erythema multiform : is a blistering hypersensitivity reaction classically characterized by limited outbreak of target lesions , usually in symmetric distribution in upper extremities , limited involvement of one mucosal surface
what is the organism responsible for erythema multiform ?
herpes simplex virus is the infectious agent , most commonly associated with erythema multiform
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stevens-johnoson syndrome (sjs): it is severe potentially life-threatening blistering hypersensitivity reaction , may demonstrate target lesions(more extensive distribution than erythema multiform )
what are the criteria of stevens-johonson syndrome ?
involvement of two or more muscosal surface (mouth , eye , urogenital , esophageal ) , also fever more likely occur with sjs
what is the infectious agent responsible for stevens-johonson syndrome ?
mycoplasma pneumonia the most common agent associated with sjs
is drug-medications may cause stevens-johonson syndrome ?
several medications are also recognized as precipitants for sjs
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Group A streptococci (GAS) : group A sterptococci associated with several characteristic skin finding , scarlatina or scarlatiniform rash or scarlet fever describe diffuse , fine papular (ashy or sandpaper) rash tends to develop initially in neck and upper chest , the rash may concentrated in creases (axilla , antecubital fossa , inguinal) where it take linear petechial appearance (pastia's lines ) subsequent desquamation of the rash particularly on the hands and feet is characteristic in both treated and untreated group A streptococci infection
what is the cause of scarlet fever ?
group A streptococci
sandpaper rash , what is the cause ?
group A streptococci
what are the criteria of scarlet fever ?
1-punctate(sandpaper) erythematous rash (second day) in neck and upper chest
2- white strawberry tongue (first day)
3- red strawberry tongue (third day)
4-pastias lines in crease (axilla , inguinal , antecubetal )