Tick Typhus
James H. S. Gear in CRC Handbook of Viral and Rickettsial Hemorrhagic Fevers, 2019
On the 3rd to the 5th day of illness, a maculopapular rash erupts first on the extremities and then on the trunk (Plate 6*). The rash appears in crops and new macules and papules may be noted each day for 1 to 3 days. The papules are relatively coarse and can be felt as small shotty nodules in the skin. At first they are pinkish, but later become darker. Characteristically, the rash involves the palms of the hands, the soles of the feet, and, to a lesser extent, the face. The profuseness of the rash is directly related to the severity of the illness. In mild cases only a few raised red papules, more evident on the limbs than on the trunk, may be seen. In severe cases, a profuse maculopapular rash covers the whole body, but tends to be centrifugal, being more marked peripherally than centrally, and the skin has a dusky cyanotic hue. In very severe cases, the rash may become hemorrhagic with bleeding into the elements of the rash, associated with numerous petechial hemorrhages in the skin which may become edematous. On recovery, especially after specific treatment, the rash rapidly resolves, but if it had become hemorrhagic, staining of the skin may be seen for some time in convalescence.
Toxic cyanobacteria *
Jamie Bartram, Rachel Baum, Peter A. Coclanis, David M. Gute, David Kay, Stéphanie McFadyen, Katherine Pond, William Robertson, Michael J. Rouse in Routledge Handbook of Water and Health, 2015
In addition to the above groups of toxins, cyanobacteria are known to produce other potentially toxic compounds. Dermatotoxic alkaloids – lyngbyatoxin and aplysiatoxins – can elicit severe dermatitis and eye irritation on contact, while ingestion or inhalation can cause mild to severe nose and throat irritation. Lipopolysaccharides expressed by most cyanobacteria act as general skin irritants upon contact. These compounds can produce symptoms (including red, blotchy, raised skin rash) similar to – and thus mistaken for – common swimmer’s itch resulting from infection by Schistosoma cercaria. Moreover, ingestion of cyanobacterial dermato- and hepato-toxins can produce symptoms similar to acute schistosomiasis including: headache, fever, severe abdominal pain and diarrhea.
Fetal infections
David M. Luesley, Mark D. Kilby in Obstetrics & Gynaecology, 2016
Parvovirus B19, also commonly referred to as fifth disease or erythema infectiosum, is a small single-stranded DNA virus that at least 50 percent of pregnant women are seropositive for and hence immune to. The virus is often asymptomatic in adults, although they may initially present with symptoms similar to a common cold followed by the classic slapped-cheek rash. Adults who are symptomatic will often experience a polyarthropathy syndrome. The virus is spread via aerosol route and those infected are contagious for 5–10 days prior to the rash developing. Significant contact is required to contract the virus. This is defined as being in the same room as the infected person for over 15 minutes, or face-to-face contact. The infection is usually seen in epidemics.
The differential effects of upadacitinib treatment on skin rashes of four anatomical sites in patients with atopic dermatitis
Published in Journal of Dermatological Treatment, 2023
Teppei Hagino, Hidehisa Saeki, Eita Fujimoto, Naoko Kanda
This study has several limitations. We could not compare the treatment responses to upadacitinib among individual features of rash, erythema, induration/papulation, excoriation, and lichenification. The differential treatment responses among different features of rash should be examined in further studies. Second, this study evaluated only the therapeutic effects of 15 mg/day of upadacitinib, and not of 30 mg/day, which should be examined in further studies. Third, there is a lack of information on the dose and rank of topical corticosteroids used for different anatomical sites. Treatment responsiveness might be affected by the dose and rank of corticosteroids, which might influence the anatomical site-dependent differences in treatment responsiveness. For instance, it is common to apply less potent corticosteroids to the face, which may result in the lower treatment response of the head and neck rash compared to that of the other sites. Therefore, future studies should record the detailed information about the topical corticosteroids for individual anatomical sites.
Otolaryngologic manifestations of Mpox: the Atlanta outbreak
Published in Acta Oto-Laryngologica, 2023
Kaitlyn A. Brooks, Nathaniel S. Neptune, Douglas E. Mattox
Patients presenting due to MPX-related pharyngitis are at risk for inappropriate diagnosis and treatment [12]. Mucosal lesions were misdiagnosed as oral thrush in one of our patients; oropharyngeal edema, ulceration, and cervical lymphadenopathy were so impressive for patient 5 that MPXV was mistaken for a tumor until the patient developed a rash. Three (50%) of our patients with odynophagia had not yet developed the pathognomonic rash, which supports that mucosal lesions and oropharyngeal symptoms can develop prior to other systemic symptoms of MPXV infection [8,11]. Rash formation often guided diagnosis in our hospitalized patients, but this would not be possible on an outpatient basis. While PCR on skin lesions is highly diagnostic, pharyngeal swabs only diagnosed MPX 70% of the time [13], highlighting the need for an accurate method to confirm Mpox from mucosal lesions.
Psoriasis complicated with metabolic disorder is associated with traditional Chinese medicine syndrome types: a hospital-based retrospective case–control study
Published in Current Medical Research and Opinion, 2023
Xiaoying Sun, Huaibo Zhao, Ruiping Wang, Hongjin Li, Yong Wu, Kan Ze, Yonghua Su, Bin Li, Xin Li
Based on the dialectical standard of TCM in the 2018 Chinese psoriasis diagnosis and treatment guide6, the patients were divided into blood-heat, blood-stasis, and non-blood-heat or blood-stasis syndrome groups based on the main symptoms, related symptoms, tongue coating, and pulse manifestation obtained by observing, hearing, questioning, and feeling the pulse.Blood-heat syndrome is mainly observed in the progressive stages of drip or plaque psoriasis. The primary symptoms include bright red skin lesions and increasing or rapidly expanding new rashes; secondary symptoms include perturbed and irritable deep-colored urine, red or crimson tongue, wiry, and slippery or thready pulse.Blood-stasis syndrome: mainly seen in the static stage of drip or plaque psoriasis The main symptoms were dark red skin lesions, thickened, infiltrated, and long-lasting rash, while the secondary symptoms include squamous and dry skin, darkish complexion or cyanotic lips and nails, menstruation with dark color or blood clots for women, purplish dark or ecchymosed tongue, sluggish or fine, and slow pulse.Non-blood-heat or blood-stasis syndrome is considered to be an “other” syndrome that does not meet the diagnostic criteria of the above two syndrome types.
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