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Non-specific viral rash
Viral exanthems present as red macules and papules. They can appear on any skin surface including the palms and soles.
Macules and papules may resemble hives. Viral exanthem lesions persist for days, unlike hives in which individual lesions last for less than 24 h.
Viral exanthem on the cheeks. Lesions are macular and papular but lack the scale seen in atopic dermatitis. Hives have a similar appearance.
Gianotti–Crosti syndrome. Pink papules on the extensor surface of the extremities, with only mild itching.
DESCRIPTION
A viral exanthem is a rash caused by a systemic viral infection; different viruses produce similar-appearing rashes.
HISTORY
Season, exposure history, and local and regional epidemiology assist with diagnosis. • Winter: respiratory viruses. • Summer and fall: enteroviruses.
PHYSICAL FINDINGS
• Generalized erythematous macules and papules, and urticarial (non-polio enteroviruses, respiratory viruses) petechial rashes mimic more serious systemic infection such as meningococcemia, periorbital edema (Epstein–Barr virus), keratoconjunctivitis (adenovirus), papular acrodermatitis of childhood (Gianotti–Crosti syndrome)—monomorphic, discrete papules and vesicles coalescing on the face, extremities, buttocks. • Unilateral laterothoracic exanthem (asymmetric periflexural exanthem) occurs on lateral thorax, near axilla, and can spread to other hemithorax and extremities. Papular purpuric gloves and socks syndrome: petechial erythema on palms and soles (parvovirus B19).
TREATMENT
Supportive: bland emollients, group V and VI topical steroids, oral antihistamines.
