Intended for healthcare professionals

List of diseases

Typical clinical features of diseases that may be suspected in cases of morbilliform rash

Measles—Fever, conjunctivitis, cough, coryza, Koplik’s spots. Red blotchy maculopapular rash behind the ears, spreading to the face, trunk, and extremities on the third to seventh day. The child is miserable.

Rubella—Mild febrile disease. The child is well. Usually a fine maculopapular rash. Post-auricular, post-cervical, and occipital nodes up to 10 days before the rash are characteristic.

Erythema infectiosum—Fever, erythematous "slapped" cheeks. Fine lacy rash on trunk. Arthritis and arthralgia are more common in adults. The rash can recur up to 21 days after initial clearing, particularly in sunlight or in the bath.

Roseola infantum—Most common in infants aged 6 months to 2 years. High temperature as high as 41 degrees for three to five days. The child is well. The temperature settles, and rash appears on the trunk.

Meningococcal septicaemia—The rash can be blanching or not and can be maculopapular in the early stages. Other features may be pallor, irritability, poor eye contact, and poor peripheral circulation.

Scarlet fever—Caused by group A streptococcal pyrogenic exotoxin. Strawberry tongue, fine punctuate blanching rash on the neck, chest, and skin folds, with circumoral pallor. The features of streptococcal sore throat may also be shown.

Kawasaki disease—Fever for five or more days, together with any four of polymorphous rash, non-purulent conjunctival injection, changes in peripheral extremities, oral mucosal changes, and cervical lymphadenopathy >1.5 cm.

Mediterranean spotted fever—Caused by Rickettsia conorii, transmitted by bites from canine ticks. Common in Africa, the Middle East, South East Asia, southern Portugal, and northern Spain. Fever, maculopapular rash, and necrotic area (eschar) at the site of the tick bite.

Henoch-Schönlein purpura—triad of purpuric rash, arthralgia, and abdominal pain. The classical distribution of the rash is on the extensor surfaces of legs and buttocks. Haematuria is a sign of renal involvement.

Adenoviruses and enteroviruses often cause upper respiratory infections in addition to a non-specific blanching maculopapular rash.