Peripheral Rashes

Peripheral Rashes.

Etiology

Description

RMSF

Rickettsia rickettsii

Rash beginning on wrists and ankles and spreading centripetally; palms and soles; blanchable macules  petechiae. Headache, myalgias, abdominal pain.

Secondary syphilis

Treponema pallidum

Copper-colored, scaly papular eruption, diffuse but prominent on palms and soles; rash never vesicular; condyloma latum.

Hand-foot-and-mouth disease

Coxsackievirus A16

Tender vesicles, erosions in mouth; 0.25-cm papules on hands and feet

Bacterial endocarditis

Streptococcus, Staphylococcus, etc.

Subacute: Osler's nodes (tender pink nodules on finger toe pads); petechiae on skin ; splinter hemorrhages. Acute: Janeway lesions (painless erythematous or hemorrhagic macules on palms and soles). New heart murmur.

Erythema multiforme

Drugs, infection…

i.e., Stephens-Johnson. Target lesions surrounded by clearing. Symmetric on knees, elbows, palms and soles.