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Paediatric, Rashes, dermatology
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The common and the dangerous
Why does an adult ED Dr have to know;• Common paediatric presentation• Useful knowledge for the lay consult• Frequent adult fast track patient
presentation• Knowledge of at risk contacts• Recognition is 99% of the problem,
treatment/advice is usually simple
Nomenclature of dermatology Classification system of different
rashes Management
Pattern recognition• Age group• Progression of rash• Associated symptoms• Lesions
Type Distribution Special features
8yo, fever, headache then rash Explosion of crops of lesions, first
face/scalp, then trunk and limbs over 1 day
Spares palms and soles
10yo, coryza, conjunctivitis, cough, fever
Maculopapular rash, starts behing ears, descends, becomes confluent on upper body
5yo girl, fever, arthralgias, malaise Day 3 rash on face, fevers resolved Day 7 lacy rash on body
4yo boy Fever, coryza, lethargy, mild
diarrhoea Painful lesions in/around mouth
1yo, high fever, irritable Day 3, florid rash, fever abates
8yo, sore throat, fever Day 2 – rash on trunk, spreads widely
3yo girl, Asian descent 3 days high fever, irritable, rash =
lower abdo and groin, hands and feet Mild transaminitis, high platelets
4yo, non blanching rash on lower limbs
Painful feet, mildly swollen Afebrile, systemically well 1 week post URTI
14 yo girl, onset of rash over 1 week, been present for 3 weeks
Seen 2 GPs Systemically well, no other Sx
5yo boy, African descent Referred by GP with massive painless
abscess on scalp for surgical review Systemically well
3yo, 1 week post first coldsore Onset of rash, mildly itchy, mild
fever, systemically well
Progression of rash Associated symptoms Be a detective! Look in/at the;
• Mouth• Hands and feet• Nappy area and creases
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