DOI: http://dx.doi.org/10.18203/issn.2455-4529.IntJResDermatol20202652

Overview of exanthems: a case series in a tertiary care hospital

Ramesh A., Thamizhinian K.

Abstract


Background: Generalized rashes are the most common conditions seen by primary care physician and the most common reason for new patient visit to dermatologists. There is often difficulty in diagnosing a generalized rash because many conditions produce similar rashes and a single condition can result in rashes with varied appearance. Accurate diagnosis is important because treatment varies depending on the cause. Hence, we decided to undertake a steady on the various presentations of exanthems in Madras medical college Chennai. To find out the incidence of exanthems in the OPD of Department of Dermatology, Venerology and Leprosy (DVL) in Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai to help in early diagnosis and treatment of the diseases.  

Methods: The study included all the newly diagnosed cases attending to the OPD of DVL, Madras Medical College, Chennai for a period of three months. Diagnosis was done based on clinical grounds and lab investigations were done whenever required.

Results: An analytical study of the medical records of patients attending the OPD of DVL, Madras Medical College, Chennai shows that maculopapular rash is the most common presentation of exanthems followed by papules, vesiculobullous, pustular, nodules, verrucous lesions.

Conclusions: The present study includes exanthems as a whole on contrary to many such studies performed in other parts of India which included rashes caused by viral infections and drugs. Our study included generalized skin eruptions due to infections, drugs, specific dermatoses, allergy.   


Keywords


Exanthems, Maculopapular rash, Papules, Nodules, Vesiculobullous

Full Text:

PDF

References


Devi TB, Zamzachin G. Pattern of skin diseases in Imphal. Indian J Dermatol. 2006;51(2):149.

Drago F, Paolino S, Rebora A, Broccolo F, Drago F, Cardo P, et al. The challenge of diagnosing atypical exanthems: A clinico-laboratory study. J Am Acad Dermatol. 2012;67(6):1282-8.

Ely JW, Osheroff JA, Ebell MH, Bergus GR, Levy BT, Chambliss ML, et al. Analysis of questions asked by family doctors regarding patient care. BMJ. 1999;319(7206):358-61.

Ely JW, Stone MS. The Generalized Rash: Part I. Differential Diagnosis. Am Fam Physician. 2010;81(6):726-34.

Drago F, Ciccarese G, Gasparini G, Cogorno L, Javor S, Toniolo A, et al. Contemporary infectious exanthems: an update. Future Microbiol. 2016;12(2):171-93.

Thomas PH. Exanthems and Drug Eruptions. In: Clinical Dermatology A color guide to Diagnosis and Therapy. sixth. Elsevier; 2016.

Drago F, Rampini P, Rampini E, Rebora A. Atypical exanthems: morphology and laboratory investigations may lead to an aetiological diagnosis in about 70% of cases. Br J Dermatol. 2002;147(2):255-60.

Keighley CL, Saunderson RB, Kok J, Dwyer DE. Viral exanthems. Curr Opin Infect Dis. 2015;28(2):139.

Salavastru CM, Stanciu AM, Fritz K, Tiplica GS. A burst in the incidence of viral exanthems. Indian Dermatol Online J. 2014;5(2):144-7.

Carolina VBC Pharm D Associate Professor, Pharmacy Practice Vice Chairman, Experiential Education Campbell University College of Pharmacy and Health Sciences Buies Creek, North Carolina Jennifer D Smith, PharmD, CPP, BC-ADM, CDE Associate Professor, Pharmacy Practice Campbell University College of Pharmacy and Health Sciences Clinical Pharmacist Practitioner, Wilson Community Health Center Buies Creek, North. Cutaneous Fungal Infections. Available at https://www.uspharmacist.com/article/cutaneous-fungal-infections. Accessed on 21 December 2019.

Kar C, Das S, Roy AK. Pattern of Skin Diseases in a Tertiary Institution in Kolkata. Indian J Dermatol. 2014;59(2):209.

Drago F, Ciccarese G, Rebora A. The changing face of the exanthems. Indian Dermatol Online J. 2014;5(3):353.

Korman A, Alikhan A, Kaffenberger B. Viral exanthems: An update on laboratory testing of the adult patient. J Am Acad Dermatol. 2016;76.

Cherry JD, Harrison GJ, Kaplan SL, Steinbach WJ, Hotez JP. Feigin and Cherry’s textbook of pediatric infectious diseases in 2013.

Altman K, Vanness E, Westergaard RP. Cutaneous manifestations of human immunodeficiency virus: a clinical update. Curr Infect Dis Rep. 2015;17(3):464.

Pincus LB, Grossman ME, Fox LP. The exanthem of dengue fever: Clinical features of two US tourists traveling abroad. J Am Acad Dermatol. 2008;58(2):308-16.

Banta J. Notes from the Field: Outbreak of Hand, Foot, and Mouth Disease Caused by Coxsackievirus A6 Among Basic Military Trainees - Texas, 2015. MMWR Morb Mortal Wkly Rep. 2016;65. Available at https://www.cdc.gov/mmwr/volumes/65/wr/mm6526a3/htm. Accesssed on 20 December 2019.

Kempf W, Burg G. Pityriasis rosea: a virus-induced skin disease. An update Arch Virol. 2000;145(8):1509-20.

Kang JH. Febrile Illness with Skin Rashes. Infect Chemother. 2015;47(3):155-66.

Differential Diagnosis in Pediatrics - A Compendium of Symptoms and Findings | H. Ewerbeck | Springer. Available at https://www.springer.com/gp/book/9781461260745. Accessed on 20 December 2019.

Martinez FAA, Alvarez GL, Hidalgo M, Oteo JA. Syndromic classification of rickettsioses: an approach for clinical practice. Int J Infect Dis IJID Off Publ Int Soc Infect Dis. 2014;28:126-39.

Cutaneous Syphilis - an overview | Science Direct Topics. Available at https://www.sciencedirect.com/topics/pharmacology-toxicology-and-pharmaceutical-science/cutaneous-syphilis. Accessed on 21 December 2019.

Lepromatous Leprosy - an overview | Science Direct Topics. Available at https://www.sciencedirect.com/topics/medicine-and-dentistry/lepromatous-leprosy. Accessed on 21 December 2019.

McCarthy JS, Kemp DJ, Walton SF, Currie BJ. Scabies: more than just an irritation. Postgrad Med J. 2004;80(945):382-7.

Nayak S, Acharjya B. Adverse cutaneous drug reaction. Indian J Dermatol. 2008;53(1):2-8.

Information NC for B, Pike USNL of M 8600 R, MD B, USA 20894. Adverse drug reactions in hospital patients: a systematic review of the prospective and retrospective studies. Centre for Reviews and Dissemination (UK); 2002. Available at https://www.ncbi.nlm.nih.gov/books/NBK69438. Accessed on 21 December 2019.

SG. Cutaneous adverse drug reactions in hospitalized patients in a tertiary care center. Indian J Pharmacol. 2004;36(5):292.

Patel TK, Thakkar SH, Sharma DC. Cutaneous adverse drug reactions in Indian population: A systematic review. Indian Dermatol Online J. 2014;5(6):76.

Leverkus M, Jochim RC, Schad S, Brocker EB, Andersen JF, Valenzuela JG, et al. Bullous allergic hypersensitivity to bed bug bites mediated by IgE against salivary nitrophorin. J Invest Dermatol. 2006;126(1):91-6.

Narayankar SL, Pandit GA. Papulo-squamous: clinicopathological. Int J Res Med Sci. 2017;6(1):309-16.

Thomas PH. Psoriasis and other papulo-squmaous diseases. In: Clinical dermatology a color guide to diagnosis and therapy. sixth. Elsevier; 2015.

Thomas PH. Pityriasis rubra pilaris. In: Clinical dermatology a color guide to diagnosis and therapy. sixth. Elsevier; 2016.

Thomas PH. Lichen planus. In: Clinical dermatology a color guide to diagnosis and therapy. sixth. Elsevier; 2016.

Weaver J, Bergfeld WF. Grover Disease (Transient Acantholytic Dermatosis). Arch Pathol Lab Med. 2009;133(9):1490-4.

Panda S. Mycosis fungoides: Current trends in diagnosis and management. Indian J Dermatol. 2007;52(1):5.

Kasperkiewicz M, Ellebrecht CT, Takahashi H, Yamagami J, Zillikens D, Payne AS, et al. Pemphigus. Nat Rev Dis Primer. 2017;3:17026.

Khandpur S, Verma P. Bullous pemphigoid. Indian J Dermatol Venereol Leprol. 2011;77(4):450.