Ref: Hallmark Rashes
- Location: facial, facial
sparing, palmar, other
locations
- Spread: bullseye, centrifugal,
centripedal, forehead
first, head-to-toe,
cheeks first
- Appearance
- By rash onset-fever onset
interval
- By pre-rash history, weird
symptom
- By patient
- Others in DDx
- Acne vulgaris.
- SLE: butterfly rash, women.
- DLE: sharp marginated, on ears, lower lip, lower eyelid, nose.
- Sarcoidosis: red-brown papules on eyelid, nostril rim.
- Rosacea: flushed, perhaps pustular.
- Photosensitivity.
- Tuberous sclerosis: angiofibromas.
- See also Slapped cheeks.
- Palmar erythema (cirrhosis).
- Meningococcus.
- Gonococcus.
- RMSF.
- 2° syphilis.
- Erythema multiforme ['target lesions'] (HSV, others).
- Ring around scalp: tinea capitis, aka ringworm.
- Facial cosmetic area: cosmetics.
- Single dermatome: shingles.
- "Christmas tree" on back: pityriasis rosea.
- Glove or shoe distribution: allergic reaction.
- Between finger digits: scabies.
- Diaper area: candida.
- Gentials and lips: herpes.
- Groin, down upper thigh: tinea curis.
- Buttock and leg: Henonch-Schonlein purpura.
- Shins: erythema nodosum [infection of fat layer] (OCP, pregnancy, sarcoid,
strep, drugs).
- Foot: tinea pedis, aka athlete's foot.
- Legs: erythema ag igne (heat rash).
- Extensor side of elbows/knees, scalp, lumbosacral: psoriasis.
- Flexor side of elbows knees: para-psoriasis, inherited eczema.
- Hands, feet, mouth: hand-foot-mouth.
- Psilver Pscale over Psalmon Pskin: Psoriasis.
- Honey crust: impetigo.
- Rashes in all stages: chicken pox.
- Like measles but finer, pinker: rubella.
- Creamy white plaques, scraped to show raw skin: candida.
- "Active edge": central clearing, but border of lesion shows
scaling: ringworm.
- Pinpoint petrochial: CMV.
- Clear center "marginosum": rheumatic fever.
- Central depression [punctum] in papule: molluscum contagium.
- Purple, Peripheral, Pruritic Polygons: lichen Planus.
- Dark blue edge around purulent ulcer: pyoderma gangrenosum.
- "Carpet tack" when remove skin: DLE.
- Cafe-au-lait:
• Neurofibromatois
• Tuberous sclerosis
"Really Sick Must Children Must Take
No Exercise":
Days after fever onset, that rash appears:
1: Rubella
2: Scarlet fever/ Smallpox
3: Chickenpox
4: Measles [with Koplik spots 1 day earlier]
5: Typhus, rickettsia [variable]
6: Nothing
7: Enteric fever [salmonella]
- Roseola: rash appears when fever disappears.
- Rubella: forehead to face to torso to extremities.
- Measles: both appears, and disappears from head to toe.
- Fifth disease [erythema infectiosum]: "slapped cheeks".
- Ate chicken: salmonella.
- Bit by tick: RMSF.
- Bit by flea: typhus.
- Chorea: rheumatic fever.
- Condyloma lata: syphilis.
- Koplik's spots: measles.
- Gross splenomegaly: EBV [others also].
- Strawberry tongue: scarlet fever.
- Fluoresce in UV light
• Yellow glow: pityriasis versicolor.
• Tinea capitis, aka ringworm.
- Nail pitting, onycholysis: psoriasis.
- Born with rash: ToRCHeS:
• Rubella.
• CMV.
• Herpes.
• Syphilis.
- Child:
• Listeria
• Measles
• Mumps
• Ruebella
• Etc.
- Very sexually active:
• Gonococcus.
• Herpes.
• Neisseria meningitis.
• Syphilis.
- Contact eczema.
- Atopic eczema.
- Drug reaction, esp. penicillins.
- Allergies.
- Heat rash.
- Histiocytosis X.