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Office of Epidemiology and Prevention Services Divisions of Infectious Disease Epidemiology www.wvidep.org Assessing Rash Characteristics Carrie A. Thomas,

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Presentation on theme: "Office of Epidemiology and Prevention Services Divisions of Infectious Disease Epidemiology www.wvidep.org Assessing Rash Characteristics Carrie A. Thomas,"— Presentation transcript:

1 Office of Epidemiology and Prevention Services Divisions of Infectious Disease Epidemiology www.wvidep.org Assessing Rash Characteristics Carrie A. Thomas, PhD Epidemiologist (VPD/IBD) Division of Infectious Disease Epidemiology West Virginia Bureau for Public Health www.wvidep.org (304) 558-5358

2 Objectives Describe features you should assess when investigating a report of a febrile rash illness Describe features you should assess when investigating a report of a febrile rash illness Review accompanying signs and symptoms associated with febrile rash illnesses Review accompanying signs and symptoms associated with febrile rash illnesses Define commonly used medical terms related to febrile rash illnesses Define commonly used medical terms related to febrile rash illnesses Office of Epidemiology and Prevention Services Divisions of Infectious Disease Epidemiology www.wvidep.org

3 Office of Epidemiology and Prevention Services Divisions of Infectious Disease Epidemiology www.wvidep.org Distribution Where is the rash located? Where is the rash located? Localized – restricted to one area of the body Localized – restricted to one area of the body Generalized – present on several areas of the body Generalized – present on several areas of the body

4 Office of Epidemiology and Prevention Services Divisions of Infectious Disease Epidemiology www.wvidep.org Distribution Where is the rash located? Where is the rash located? Localized – restricted to one area of the body Localized – restricted to one area of the body Generalized – present on several areas of the body Generalized – present on several areas of the body Localized rash – Lyme Disease Generalized rash – Rubella

5 Office of Epidemiology and Prevention Services Divisions of Infectious Disease Epidemiology www.wvidep.org Progression Did the rash move over the body during the course of illness? Did the rash move over the body during the course of illness? Smallpox on first day of skin rash onset

6 Office of Epidemiology and Prevention Services Divisions of Infectious Disease Epidemiology www.wvidep.org Color What color is the rash? What color is the rash? Rashes can appear red, white, purple or silver Rashes can appear red, white, purple or silver Is the color uniform or patchy/blotchy? Is the color uniform or patchy/blotchy?

7 Office of Epidemiology and Prevention Services Divisions of Infectious Disease Epidemiology www.wvidep.org Color What color is the rash? What color is the rash? Rashes can appear red, white, purple or silver Rashes can appear red, white, purple or silver Is the color uniform or patchy/blotchy? Is the color uniform or patchy/blotchy? MeningococcemiaMeasles

8 Office of Epidemiology and Prevention Services Divisions of Infectious Disease Epidemiology www.wvidep.org Texture Rashes can be flaky, scaly, bumpy or smooth and the texture of the bumps may range from fine to course and can be solid or fluid-filled Rashes can be flaky, scaly, bumpy or smooth and the texture of the bumps may range from fine to course and can be solid or fluid-filled Scarlet feverChickenpox

9 Office of Epidemiology and Prevention Services Divisions of Infectious Disease Epidemiology www.wvidep.org Additional details Record additional details about the rash Record additional details about the rash Is it itchy? Is it itchy? Is it sore? Is it sore? Is it numb or tingly? Is it numb or tingly? Is it scabbing or crusty? Is it scabbing or crusty? If there’s fluid involved, what color? If there’s fluid involved, what color?

10 Office of Epidemiology and Prevention Services Divisions of Infectious Disease Epidemiology www.wvidep.org Accompanying signs and symptoms Ask about additional signs/symptoms (and their timing in relation to rash onset date) Ask about additional signs/symptoms (and their timing in relation to rash onset date) Fever, highest recorded temperature Fever, highest recorded temperature Cough Cough Conjunctivitis Conjunctivitis Respiratory symptoms, including runny nose Respiratory symptoms, including runny nose Joint pain Joint pain Swollen lymph nodes Swollen lymph nodes Fatigue Fatigue

11 Case Study Get a report from a school that they have an outbreak of a rash illness Get a report from a school that they have an outbreak of a rash illness What’s the first thing you want to know? What’s the first thing you want to know? Office of Epidemiology and Prevention Services Divisions of Infectious Disease Epidemiology www.wvidep.org

12 Case Study – Line List Patient Rash Description Distribution/ Location ProgressionColorTextureS&S Case 1Rash on trunk and face Started on face then body Face – bright red; trunk – red RoughFever, headache Case 2Face, bodyFace then body Face – dark red; body red Face – bumpy Runny nose, fever Case 3Trunk and extremities Just saw it on trunk and extremities Red, appears like a lace pattern SmoothAbdominal pain, fever, headache Case 4torsoSaw it on torso Dark pinkDid not touch it Nausea, vomiting, fever, URTI Office of Epidemiology and Prevention Services Divisions of Infectious Disease Epidemiology www.wvidep.org

13 Case Study Get a report from a school that they have an outbreak of a rash illness Get a report from a school that they have an outbreak of a rash illness What’s the first thing you want to know? What’s the first thing you want to know? Office of Epidemiology and Prevention Services Divisions of Infectious Disease Epidemiology www.wvidep.org Fifth Disease aka Parvovirus B19

14 Medical Terms Papule - A small solid rounded bump rising from the skin (scarlet fever) Papule - A small solid rounded bump rising from the skin (scarlet fever) Vesicle - a small blister filled with fluid (Hand, Foot & Mouth Disease) Vesicle - a small blister filled with fluid (Hand, Foot & Mouth Disease) Macule - A small localized change in the color of skin that is neither raised (elevated) nor depressed (Rocky Mountain Spotted fever) Macule - A small localized change in the color of skin that is neither raised (elevated) nor depressed (Rocky Mountain Spotted fever) Pruritic – itchy Pruritic – itchy Erythematous – red Erythematous – red Petechiae - Pinpoint flat round red spots under the skin surface caused bleeding into the skin (do not turn pale with pressure) Petechiae - Pinpoint flat round red spots under the skin surface caused bleeding into the skin (do not turn pale with pressure) Purpura - A hemorrhagic area in the skin. Early purpura is red and becomes darker, then purple, and brown-yellow as it fades. Does not blanch when touched. Purpura - A hemorrhagic area in the skin. Early purpura is red and becomes darker, then purple, and brown-yellow as it fades. Does not blanch when touched. Office of Epidemiology and Prevention Services Divisions of Infectious Disease Epidemiology www.wvidep.org

15 Summary Distribution / Location Distribution / Location Progression Progression Color Color Texture Texture Additional info about the rash presentation Additional info about the rash presentation Itchy, sore, numb, etc. Itchy, sore, numb, etc. Accompanying signs and symptoms Accompanying signs and symptoms Fever, cough, respiratory symptoms, etc. Fever, cough, respiratory symptoms, etc. Office of Epidemiology and Prevention Services Divisions of Infectious Disease Epidemiology www.wvidep.org


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