Dermatologic manifestations of bacterial and viral infections

b. Secondary syphilis -- maculopapular rash, condylomata lata (flat topped papules -- located at the anus and in skin folds where heat and moisture exist).

c. Rocky Mountain Spotted Fever -- stage 1: erythema chronicum migrans (a red rash that spreads, leaving a clear center -- bulls-eye rash).

d. Meningococcemia --intravascular multiplication of N. meningitidis in the blood can result in a petechial rash (minute hemorrhagic spots the size of a pin that do not blanch when pressed). The rash can enlarge if the organisms multiply in the blood to the leading to fulminant meningococcemia (Waterhouse-Friderichsen syndrome--bilateral hemorrhage into the adrenals).

e. Herpes Zoster (varicella zoster) Virus -- vesicular rash (chicken-pox) that appear on the back of the head and ears then spread to the face, neck, trunk, and extremities. The distinguishing feature from other rashes (small pox) is that lesions will be at different stages (whereas small pox lesions are concentrated on the extremities and are all in the same stage). The lesions are very pruritic (itchy).

f. Coxsackievirus --Coxsackie A: herpangina -- fever, sore throat, and small red-based vesicles over the back of the throat. Hand-foot-mouth disease -- (coxsackie A-16) eruptions of small pearly, gray vesicles on the fingers, toes, palms, and soles often accompanied by painful vesicles and ulceration of the buccal mucous membranes and the tongue with slight fever; disease lasts 4 to 7 days.

Category: Dermatology Notes