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Assessing Rash Characteristics

Assessing Rash Characteristics. Carrie A. Thomas, PhD Epidemiologist (VPD/IBD) Division of Infectious Disease Epidemiology West Virginia Bureau for Public Health www.wvidep.org (304) 558-5358. Objectives.

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Assessing Rash Characteristics

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  1. Assessing Rash Characteristics Carrie A. Thomas, PhD Epidemiologist (VPD/IBD) Division of Infectious Disease Epidemiology West Virginia Bureau for Public Health www.wvidep.org (304) 558-5358

  2. Objectives • Describe features you should assess when investigating a report of a febrile rash illness • Review accompanying signs and symptoms associated with febrile rash illnesses • Define commonly used medical terms related to febrile rash illnesses

  3. Distribution • Where is the rash located? • Localized – restricted to one area of the body • Generalized – present on several areas of the body

  4. Distribution • Where is the rash located? • Localized – restricted to one area of the body • Generalized – present on several areas of the body Localized rash – Lyme Disease Generalized rash – Rubella

  5. Progression • Did the rash move over the body during the course of illness? Smallpox on first day of skin rash onset

  6. Color • What color is the rash? • Rashes can appear red, white, purple or silver • Is the color uniform or patchy/blotchy?

  7. Color • What color is the rash? • Rashes can appear red, white, purple or silver • Is the color uniform or patchy/blotchy? Meningococcemia Measles

  8. Texture • Rashes can be flaky, scaly, bumpy or smooth and the texture of the bumps may range from fine to course and can be solid or fluid-filled Scarlet fever Chickenpox

  9. Additional details • Record additional details about the rash • Is it itchy? • Is it sore? • Is it numb or tingly? • Is it scabbing or crusty? • If there’s fluid involved, what color?

  10. Accompanying signs and symptoms • Ask about additional signs/symptoms (and their timing in relation to rash onset date) • Fever, highest recorded temperature • Cough • Conjunctivitis • Respiratory symptoms, including runny nose • Joint pain • Swollen lymph nodes • Fatigue

  11. Case Study • Get a report from a school that they have an outbreak of a rash illness • What’s the first thing you want to know?

  12. Case Study – Line List

  13. Case Study • Get a report from a school that they have an outbreak of a rash illness • What’s the first thing you want to know? Fifth Disease aka Parvovirus B19

  14. Medical Terms • Papule - A small solid rounded bump rising from the skin (scarlet fever) • Vesicle - a small blister filled with fluid (Hand, Foot & Mouth Disease) • Macule - A small localized change in the color of skin that is neither raised (elevated) nor depressed (Rocky Mountain Spotted fever) • Pruritic – itchy • Erythematous – red • Petechiae - Pinpoint flat round red spots under the skin surface caused bleeding into the skin (do not turn pale with pressure) • Purpura - A hemorrhagic area in the skin. Early purpura is red and becomes darker, then purple, and brown-yellow as it fades. Does not blanch when touched.

  15. Summary • Distribution / Location • Progression • Color • Texture • Additional info about the rash presentation • Itchy, sore, numb, etc. • Accompanying signs and symptoms • Fever, cough, respiratory symptoms, etc.

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