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Papulosquamous Diseases
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Melek Aslan Kayıran, Jordan V. Wang, Ayşe Serap Karadağ
In typical PR cases, annular lesions are prominent. The first emerging lesion is called the “herald patch,” which is frequently seen on the trunk. The herald patch is an ovoid, erythematous, scaly annular plaque with slightly raised edges and a diameter of 2–10 cm (Figure 4.13). After this lesion present, erythematous, ovoid plaques with a diameter of 5–10 mm emerge after 3–4 days in children and 1–2 weeks in adults. These lesions have a slightly gray peripheral collarette of scale (Figure 4.14). These typically form along the Langer’s lines of the trunk and proximal extremities, which can resemble a pine tree of a Christmas tree pattern. Pruritus can be seen in 25% of patients. Before skin lesions appear, some patients may experience weakness, anorexia, mild fever, and enanthema.
Infection and immunology
Published in Jagdish M. Gupta, John Beveridge, MCQs in Paediatrics, 2020
Jagdish M. Gupta, John Beveridge
5.18. Which of the following is/are characteristic of measles?Rhinitis.Conjunctivitis.Cough,Enanthem.Normal temperature when rash appears.
Unexplained Fever in Infectious Diseases Section 1: Viruses, Chlamydia, Mycoplasma, Rickettsiae, Higher Bacteria, Cell-Wall Deficient Bacteria, And Fungi
Published in Benedict Isaac, Serge Kernbaum, Michael Burke, Unexplained Fever, 2019
The primary disease is asymptomatic in 60% of cases, limited to skin-test conversion;166 in symptomatic cases fever associated with cough, headache, and chest pain is one of the most frequent symptoms.166 Rare but atypical and misleading symptoms can be associated: the so-called “toxic erythema” of short duration is a macular diffuse rash covering the trunk and extremities, sometimes associated with oral enanthem;166 the so-called “Valley Fever” associates, erythema nodosum, erythema multiforme, arthritis and arthralgia and a mild conjunctivitis sometimes accompanied by episcleritis or keratitis. Eosinophilia, sometimes very high, is frequent. Skin tests and serodiagnosis are very helpful. The pulmonary manifestations may also present as U.F.
Spotted fever diagnosis: Experience from a South Indian center
Published in Pathogens and Global Health, 2021
Elangovan D, Perumalla S, Gunasekaran K, Rose W, Verghese V p, Abhilash K Pp, Prakash Jaj, Dumler Js
This prospective study was undertaken in the Department of Clinical Microbiology, Christian Medical College, Vellore from December 2017 to May 2019. Following Ethics Committee clearance (IRB min No. 11013 dated 4 December 2017), eligible individuals were consented into the study. The study population included individuals of either sex and any age with acute undifferentiated fever (without localizing signs) of ≤15 days’ duration and rash whose samples were sent for spotted fever Rickettsia serology. Exclusion criteria included those with malaria, sepsis, enteric fever, drug-induced rashes, pustular rashes, viral exanthem or enanthem. Individuals with drug rash, pustular rashes, viral exanthems and enanthems were excluded by the physicians using detailed history and physical examination. Malaria was ruled out by testing three consecutive EDTA blood specimens by quantitative buffy coat (QBC venous tube, Tosoh India Pvt Ltd, Thane, India). Automated blood culture system (BacT/Alert, bioMerieux, Durham, NC, USA) was used to exclude enteric fever and septicemia (minimum one set of two bottles each). ELISA to detect NS1 Antigen, IgM and IgG antibodies (J. Mitra & Co. Pvt. Ltd., New Delhi, India) was performed to exclude dengue.
Cutaneous manifestations related to the COVID-19 pandemic: a review article
Published in Cutaneous and Ocular Toxicology, 2021
Hamideh Molaee, Fakhri Allahyari, Seyed Naser Emadi, Shokofeh Radfar, Zahra Razavi
A cutaneous drug reaction may clinically mimic a generalized viral exanthema. Differentiation between adverse cutaneous drug reaction and viral exanthema in some situations is crucial and challenging, however, some important points help distinguish between these two entities. Viral exanthema frequently presents on the buttocks, face, hands, and feet after or at the same time with constitutional symptoms (fatigue, headache, conjunctivitis, etc) and it might be associated with enanthema. On the other hand, adverse cutaneous drug reactions may involve the trunk and proximal extremities without prodromal signs and symptoms. Therefore, all medical practitioners must be well informed about the difference between viral exanthema and cutaneous drug reactions. Because misdiagnosis serious adverse drug reaction as viral exanthema might be ended in the death of patients32.
Dolutegravir monotherapy: an option for highly adherent HIV1-infected naive patients with relatively low zenith HIV-RNA?
Published in Infectious Diseases, 2019
Massimiliano Lanzafame, Sebastiano Rizzardo, Daniela Piacentini, Emanuela Lattuada, Sheila Chiesi, Sandro Vento
Statistical analysis was performed using t-test for unpaired data (considering p < .01 as statistically significant). The first cohort (group A) was composed of 25 (19 men) antiretroviral naive patients, enrolled between February 2015 and October 2017, and included 20 patients reported previously,2 who started dolutegravir monotherapy 50 mg once daily, after a written informed consent. The second cohort (group B) consisted of 20 patients (15 men) who started abacavir/lamivudine/dolutegravir between March 2016 and December 2016. All the patients of both cohorts were naive to HAART, with no genotypic resistance mutations at baseline and no HCV or HBV coinfection. The mean age was not significantly different (37.4 vs. 43.3 years) (p = .08). Risk factor for HIV acquisition was mainly homosexual intercourses in both the groups [in group A 15 men who have sex with men (MSM) and five heterosexual subjects; in group B 15 MSM, seven heterosexual and three bisexual subjects]. The mean zenith HIV-RNA was 33,700 (range 1400–96,600 copies/ml) in group A and 387,501 (range 1760–6,230,000 copies/ml) in group B (p = .2). Only four patients in group B had a zenith HIVRNA > 100,000 copies/ml. Mean TCD4+ lymphocytes at baseline were similar (352/µL vs. 367.7/µL) (p = .8). In March 2018, the mean length of follow-up on antiretroviral therapy was 22.4 months for patients on dolutegravir monotherapy vs. 18.4 months for patients on combination therapy (p = .16). Virological failure occurred in three patients on dolutegravir monotherapy; an additional patient stopped the drug following the appearance of an enanthema after few days of treatment. Two patients on abacavir/lamivudine/dolutegravir had a virological failure, and one additional patient was lost to follow-up. One of the failed patients on abacavir/lamivudine/dolutegravir had a zenith HIV-RNA > 100,000 copies/ml.