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PEDIATRICS

COMPLICATIONS

Hyperpigmentation can occur (especially in patients with dark skin color) due

to chronic skin inflammation.

Exanthems and Enanthems

■ Exanthem: An eruption on a skin surface

■ Enanthem: An eruption on a mucous membrane

MEASLES(RUBEOLA)

■ Viral infection (RNA virus)

■ Incidence of infection reduced by 98% after vaccination introduced in

1963

■ Transmitted by respiratory droplets

■ Incubation 10–12 days between exposure and onset of symptoms

SYMPTOMS/EXAM

■ High fever (up to 104°F).

■ Cough, conjunctivitis, coryza (nasal congestion)

■ Exanthem: Erythematous, nonblanching, maculopapular rash that

starts at the hairline, thenspreads down face, to trunk/extremities (see

Figure 5.7).

■ Enanthem:Koplik spots(pinpoint-sized white spots with red background

which appear on the buccal mucosa opposite molars; see Figure 5.8).

■ Rash may coalesce into salmon-colored patches, then disappear typically

within 1 week of onset.

DIAGNOSIS

■ Clinical diagnosis may be challenging, particularly since many physicians

rarely see patients with the diagnosis.

Measles (rubeola): Fever and

rash with cough, conjuctivitis,

coryza, and Koplik spots

FIGURE 5.6. Pityriasis rosea.

(Reproduced, with permission, from Wolff K, Johnson RA, Suurmond D. Fitzpatrick’s Color

Atlas & Synopsis of Clinical Dermatology,5th ed. New York: McGraw-Hill, 2005:119.)