TY - JOUR
T1 - Rash Decisions
T2 - An Approach to Dangerous Rashes Based on Morphology
AU - Santistevan, Jamie
AU - Long, Brit
AU - Koyfman, Alex
N1 - Publisher Copyright:
© 2016
PY - 2017/4/1
Y1 - 2017/4/1
N2 - Background Rash is a common complaint in the emergency department. Many causes of rash are benign; however, some patients may have a life-threatening diagnosis. Objective This review will present an algorithmic approach to rashes, focusing on life-threatening causes of rash in each category. Discussion Rash is common, with a wide range of etiologies. The differential is broad, consisting of many conditions that are self-resolving. However, several conditions associated with rash are life threatening. Several keys can be utilized to rapidly diagnose and manage these deadly rashes. Thorough history and physical examination, followed by consideration of red flags, are essential. This review focuses on four broad categories based on visual and tactile characteristic patterns of rashes: petechial/purpuric, erythematous, maculopapular, and vesiculobullous. Rashes in each morphologic group will be further categorized based on clinical features such as the presence or absence of fever and distribution of skin lesions. Conclusions Rashes can be divided into petechial/purpuric, erythematous, maculopapular, and vesiculobullous. After this differentiation, the presence of fever and systemic signs of illness should be assessed. Through the breakdown of rashes into these classes, emergency providers can ensure deadly conditions are considered.
AB - Background Rash is a common complaint in the emergency department. Many causes of rash are benign; however, some patients may have a life-threatening diagnosis. Objective This review will present an algorithmic approach to rashes, focusing on life-threatening causes of rash in each category. Discussion Rash is common, with a wide range of etiologies. The differential is broad, consisting of many conditions that are self-resolving. However, several conditions associated with rash are life threatening. Several keys can be utilized to rapidly diagnose and manage these deadly rashes. Thorough history and physical examination, followed by consideration of red flags, are essential. This review focuses on four broad categories based on visual and tactile characteristic patterns of rashes: petechial/purpuric, erythematous, maculopapular, and vesiculobullous. Rashes in each morphologic group will be further categorized based on clinical features such as the presence or absence of fever and distribution of skin lesions. Conclusions Rashes can be divided into petechial/purpuric, erythematous, maculopapular, and vesiculobullous. After this differentiation, the presence of fever and systemic signs of illness should be assessed. Through the breakdown of rashes into these classes, emergency providers can ensure deadly conditions are considered.
KW - erythema
KW - maculopapular
KW - petechiae
KW - purpura
KW - rash
KW - vesiculobullous
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U2 - 10.1016/j.jemermed.2016.10.027
DO - 10.1016/j.jemermed.2016.10.027
M3 - Article
C2 - 27913079
AN - SCOPUS:85007322560
SN - 0736-4679
VL - 52
SP - 457
EP - 471
JO - Journal of Emergency Medicine
JF - Journal of Emergency Medicine
IS - 4
ER -