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Background

An exanthem is a skin eruption occurring as a symptom of a general disease, usually an infectious process. The following tables list several clinical differential diagnoses that should be considered when encountering a patient with these symptoms.

EXANTHEMATOUS ILLNESSES WITH PETECHIAE

SKIN PETECHIAE (EXANTHEM) Enterovirus
EBV
CMV
Meningococcemia
Gonococcemia (pustules more common)
Rocky Mountain spotted fever
Henoch-Schonlein purpura
Rat bite fever
Ehrlichiosis
Dengue fever
Leptospirosis
ORAL MUCOSAL PETECHIAE (ENANTHEM) GABHS
Rubella
EBV
Arcanobacterium haemolyticum

RASH INVOLVING THE HANDS AND FEET

BACTERIAL Rocky Mountain Spotted Fever
VIRAL Hand-Foot-Mouth disease
Papular-purpuric gloves and socks syndrome (Parvovirus B19 infection)
OTHER Kawasaki's disease
NON-INFECTIOUS Erythema multiforme

PHARYNGITIS AND RASH IN YOUNG ADULTS

BACTERIAL GABHS
Arcanobacterium haemolyticum
Staphylococcus aureus
Secondary syphilis
Gonorrhea
VIRAL EBV
CMV
Enterovirus

Fitzpatrick's Dermatology in General Medicine. Fifth Edition. McGraw-Hill. 1999.

Last Updated 1/1/2001

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