DERMATOLOGY
Measles (Rubeola)■ Highly contagious viral illness spread by infectious droplets. Starts with
fever up to 40.5°C, then cough, coryza, and conjunctivitis.
■ Koplik spots (pathognomonic of the disease) appear on the buccal
mucosa opposite the lower molars as small, irregular, bright red spots with
bluish-white centers.
■ Cutaneous eruption begins on third day of illness with maculopapular ery-
thematous lesions beginning on head especially behind the ears and
around the hairline and progressing to feet.ROSEOLA INFANTUM (EXANTHEMA SUBITUM OR SIXTH DISEASE)■ Caused by human herpes virus; majority of cases occur between 6 months
and 3 years.
■ Illness starts with abrupt onset of high fever (104–105°F) although infant
seems well.Defervescence of feveris associated with onset of rose pink
macules and papules 2–3 mm in diameter, which blanch on pressure and
rarely coalesce, appear on the trunk, and then spread to the extremities,
and may be accompanied by lymphadenopathy.
■ The rash disappears over 1–2 days.
■ Febrile seizures may rarely occur.FIGURE 17.9. Scarlet fever.(Reproduced, with permission, from Knoop KJ, Stack LB, Storrow AB. Atlas of Emergency
Medicine, 2nd ed. New York: McGraw-Hill, 2002:455.)