피부 발진과 열나는 질병들 Diseases with skin rash and fever

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부모도 반의사가 되어야 한다
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이상원 저작 및 저서
1. http://www.koreapediatrics.com/부모도 반의사가 되어야 한다–약 20,000 여 쪽. 13412 제목, 2013년 출시 소아과 웹사이트 이상원 운영
2.소아가정의학 백과-618쪽, 1988년 출간
3.소아가정간호백과–부모도 반의사가 되어야 한다-1076쪽, 1998년 청문각 출간
4.신생아 영유아 학령기아 사춘기아 성장발육 육아-623쪽 2014년 좋은땅 출간
5.신생아 성장 발육 양호 질병, 610쪽 2014년 좋은땅 출간
6.모유 모유수유 이유 308쪽, 2014년 좋은땅 출간
7.소아청소년 뇌전증(간질)+뇌전증 백문 백답, 240쪽 2015년 좋은땅 출간
8.임신에서 신생아 돌보기까지, 약 300쪽 1998년 청문각 출간
9.아들 딸 이렇게 사랑해서 키우세요, 210쪽 역저 전 세계 명작 Ross Campbell 의학박사 저 1988년 서문당 출간
11.마약과 아이들 약 200쪽 , 1988년 출간
12.아들 딸 조건 없는 진정한 사랑으로 키우세요 그리고 인성교육은 이렇게 2016년 양서각 출간 647쪽
13.”https://www.flickr.com/people/drleesangwon
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17.그 외의 포스팅 내용의 대부분은 www.koreapediatrics.com에 있는 내용들입니다. 전문적인 면도 있지만 소아청소년 자녀 양육에 많은 도움이 되리라고 믿습니다. 그러나 여기에 있는 정보는 여러분의 의사로부터 얻는 정보와 치료를 대신할 수 없습니다. www.koreapediatrics.com 부모도 반의사가 되어야 한다저자 이상원연세대학교 의과대학 졸업
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미국 커네티컷 UCONN 의과대학, 예일대학교 의과대학 소아과 수련
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Diseases with Skin Rash and Fever

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Diseases with Skin Rash and Fever

● Many diseases in children and adolescents (ages 0-18) cause fever and a rash.
● Here are some of the many diseases that cause fever and a rash.
● Diseases with a rash but no fever
● Diseases with a fever but no rash
● Or diseases with a rash and a fever are described below.

■ Various Types of Skin Rashes
(See Photo 2 on p.00)
● Erythema – Red spots caused by congested capillaries
● Papules – Circular, superficial, hard, raised skin rashes that are confined to the epidermis
● Vesicles – Fluid-filled vesicles or raised skin bumps the size of millet or gourds, sometimes containing serous fluid
● Pustules – Skin spots formed by pus within or beneath the epidermis
● Purpura – Vivid or reddish-brown skin spots caused by inflammation, infection, or bleeding within the walls of blood vessels within tissues. These may or may not be palpable, but are easily visible to the naked eye.
● Petechiae – Slightly raised, reddish-purple, circular petechiae caused by bleeding within the skin or submucosal layers

■ The following infections or diseases may cause a rash alone or both.

1. Scarlet fever
2. Meningococcal sepsis and/or meningococcal meningitis
3. Lyme disease and/or Lyme arthritis
4. Impetigo contagiosa
5. Toxic epidermal necrolysis or scalded skin syndrome
6. Rubeola (Measles)
7. Rubella (3-day measles)
8. Exanthem subitum (Roseola)
9. Chickenpox (Varicella)
10. Erythema infectiosum (Fifth disease)
11. Herpes zoster (Shingles)
12. Herpes zoster Rash (Herpes simplex skin infection)
13. Infectious mononucleosis skin eruption
14. Hand, foot, and mouth disease
15. Adenoviral exanthem
16. Enteroviral exanthem
17. Rotavirus exanthem
18. Pityriasis rosea
19. Erythema multiforme (Stevens-Johnson’s syndrome)
20. Rocky Mountain spotted fever
21. Asymmetric periflexural exanthem of childhood (Apec)
22. Papular purpura Papular-purpuric gloves and socks syndrome
23. Rheumatic fever and/or rheumatoid arthritis
24. Juvenile rheumatoid arthritis
25. Kawasaki disease (Mucocutaneous lymph node syndrome)
26. Systemic lupus erythematosus
27. Gianotti-Crosti syndrome
28. When treating a non-febrile illness with medication, the medication may cause a skin rash and fever as a side effect.
29. When treating an infectious disease with medication, the medication may cause a skin rash and fever as a side effect.
30. Other
※Source and references: Pediatric Annals, October 2010

1. Scarlet Fever
● Scarlet fever can occur when pharyngitis or pharyngotonsillitis is caused by infection with group A beta-hemolytic streptococci.
● Rarely, scarlet fever can be caused by infection with group A beta-hemolytic streptococci in a skin wound.
● The scarlet fever rash is caused by the toxins of group A beta-hemolytic streptococci that caused pharyngitis or pharyngotonsillitis.
● Symptoms and signs may include fever, sore throat, aches and pains in the arms, legs, and body, vomiting, and headache.
● An erythematous papular rash may appear on the face, neck, chest, abdomen, and hands.
● The skin rash may have a sandpaper-like appearance.

Figure 75. A red, strawberry-shaped tongue caused by scarlet fever.
Copyright ⓒ 2012 John Sangwon Lee, M.D. FAAP

Figure 76. Group A beta-hemolytic streptococci, such as those causing hemolytic streptococcal tonsillitis and scarlet fever, can cause the tongue to appear red, strawberry-like.
Copyright ⓒ 2012 John Sangwon Lee, MD. FAAP

▴ Figure 77. Thin peeling of the skin on the palms due to scarlet fever.
Copyright ⓒ 2012 John Sangwon Lee, M.D. FAAP

▴ Figure 78. Scarlet fever causes a red, rough, sandpaper-like rash.
Health information service, Merk Sharp & Dome, West Point, PA

● The tongue may appear red, strawberry-like, or red, beef-colored.
● The pharynx and tonsils may become red and enlarged.
● This disease can be easily diagnosed by combining the medical history, symptoms, signs, and physical findings.
● A quick strep test for group A beta-hemolytic streptococci antigens and antibodies, or a swab of mucus from the pharyngeal tonsils A sample is collected and cultured for group A beta-hemolytic streptococci to confirm the diagnosis.
● Treat with antibiotics. See P.000 Scarlet Fever.

2. Lyme Disease and Lyme Arthritis

See P.000

▴ Photo 79. Chronic erythema migrans on the left anterior chest due to Lyme disease.
Copyright ⓒ 2012 John Sangwon Lee, MD. FAAP

▴ Photo 80. Chronic erythema migrans on the left back due to Lyme disease.
Copyright ⓒ 2012 John Sangwon Lee, MD. FAAP

● This is an infectious disease caused by the bacteria Borrelia burgdorferi.
● It can cause arthritis, carditis, or meningitis.
● Chronic erythema migrans (Erythema chronicum migrans) can also occur.
● Chronic erythema migrans can be circular or oval in shape.
● One or more rashes may appear simultaneously on the face, neck, trunk, or legs.
● The center may be the same color as normal skin.
● Chronic erythema migrans may appear entirely red.
● Chronic erythema migrans can also occur with Lyme disease, and primary Lyme disease dermatitis can occur when the bacteria that cause Lyme disease directly infect the skin. Source-18
● Diagnosis is based on medical history, symptoms, physical examination findings, and Lyme disease testing.
● Lyme disease in children and adolescents under 12 years of age is treated with antibiotics such as Amoxicillin.
● Lyme disease in children over 12 years of age is treated with antibiotics such as Doxycycline.
● See P.000 for Lyme Disease.

3. Meningococcal Sepsis and/or Meningococcal Meningitis

▴ Photo 81. Skin hemorrhagic spots caused by meningococcal sepsis
Used with permission from Ross lab. Columbia Ohio. USA

▴ Photo 82. Purpura and blisters caused by meningococcal sepsis.
Source: 10

● Meningococcal sepsis is an infectious disease caused by meningococcal infection.
● Initially, symptoms resemble a cold, but severe systemic symptoms such as high fever, headache, low blood pressure, coma, and convulsions can quickly develop.
● Direct skin infection with this bacterium can cause meningococcal dermatitis.
● Erythematous papules and petechial hemorrhagic spots similar to a measles rash can appear.
● Thrombocytopenia and blood coagulation disorders can cause generalized purpura and petechial hemorrhagic spots.
● Diagnosis is based on medical history, symptoms, physical examination, and bacterial cultures, and treatment is administered with appropriate intravenous antibiotics. p.00 Meningococcal Sepsis Meningitis
Source and References: Pediatric Skin Rashes, Pediatric Annals, October 2010

4. Infectious Impetigo
Impetigo contagiosa
● This is a bacterial dermatitis caused by infection with group A beta-hemolytic streptococci or Staphylococcus aureus.

▴ Photo 83. Impetigo.
Copyright ⓒ 2012 John Sangwon Lee, M.D. FAAP

● It commonly appears on the skin of the face, neck, extremities, and trunk.
● One or more impetigo rashes may appear simultaneously.
● Erythema, blisters, pustules, and crusts may develop.

● Impetigo can be treated by applying topical medications such as Bactroban cream, Retapamulin ointment, or Centany (Mupirocin ointment) 2% ointment (Source: Contemporary Pediatrics June 2007), or by oral antibiotics such as Oxacillin.
● See Impetigo.
● Source and References: Pediatric Skin Rashes, Pediatric Annals, October 2010

5. Scalded Skin Syndrome (Staphylococcal Scalded Skin Syndrome)
Staphylococcal Scalded Skin Syndrome (Scalded Skin Syndrome)

● Scalded skin syndrome is an acute skin condition caused by a bacterial toxin reaction, such as Staphylococcus aureus.
● Dermatitis develops similarly to that of a severe second-degree burn.
● It is more common in infants and school-age children under 10 years of age. ● Lesions such as erythematous spots, epidermal peeling, flaking, and scaling may appear on the skin, along with systemic symptoms such as malaise, fever, and nervousness.
● A sandpaper-like erythematous rash may also develop.
● These rashes spread from hairless areas to the entire body, appearing around the lips and between the fingers.
● If this disease is suspected based on medical history, symptoms, and physical findings, a staphylococcal culture test is performed to diagnose the disease.
● Treatment is with anti-staphylococcal antibiotics such as vancomycin, clindamycin, or oxacillin, followed by symptomatic treatment.
● Source and References: Pediatric Skin Rashes, Pediatric Annals, October 2010

7. Measles
Rubeola (Measles)

● Measles is a systemic viral infection caused by the measles virus.

● Typical measles symptoms include fever and malaise for the first 24-48 hours after the onset of illness, followed by the three symptoms (3CS) of cough, runny nose, and conjunctivitis.
● Koplik spots appear on the oral mucosa 1-2 days before the measles bloom.
● One to two days after the spots appear, an erythematous papular rash (measles bloom) begins to appear on the skin behind the ear and spreads to the face, trunk, arms, legs, and hands over 2-4 days.
● Measles blooms typically disappear in the order they appeared over 5-8 days.
● Measles blooms differ from mild measles, which occurs in children who have received the measles vaccine and have developed immunity to measles but whose antibodies have largely disappeared, or from natural measles virus infection in unvaccinated children.

● Diagnosis is based on a comprehensive review of medical history, symptoms, and physical findings.
● Symptomatic treatment is provided. Antiviral medications are also used.
Source and References: Pediatric Skin Rash, Pediatric Annals, October 2010

8. Rubella
Rubella (3-day measles)

● Rubella is an acute, systemic viral infection caused by the rubella virus.

▴ Figure 85. Rubella-related skin rash and enlarged lymph nodes behind the ear and at the base of the scalp.
Source: Health Information Service,
Merk Sharp & Dome, West Point, PA

● Rubella can cause the following symptoms:
1. Headache,
2. Eye pain,
3. Sore throat,
4. Low-grade fever,
5. Fever, etc. Symptoms persist for 3-4 days. 6. The lymph nodes in the neck area below the occipital bone, behind the ears, and below them may become enlarged and painful.
7. Four to five days after the onset of this disease, a light pink rash, erythematous rash, and papules begin to appear on the hairless areas of the forehead and behind the ears, then spread to the face, neck, trunk, abdomen, arms, and legs.
8. These spots naturally disappear after two to three days.
● Diagnosis is based on a comprehensive review of medical history, symptoms, and physical examination findings.
● If contracted during the first trimester of pregnancy, the fetus may develop congenital rubella syndrome.
● Postnatal complications include cataracts, congenital heart defects, deafness, pneumonia, enlarged liver and spleen, and thrombocytopenia.

● [Parents Should Be Half-Doctors Too – Encyclopedia of Pediatric Home Nursing] – Volume 6: Diseases Protecting Neonatal Growth and Development – Congenital Rubella Syndrome.
■ Source and References:
Pediatric Skin Rash, Pediatric Annals, October 2010

9. Roseola (Sudden Rash)
Exanthem subitum (Roseola)

● This is an acute viral infection caused by infection with human herpesvirus 6 or human herpesvirus 7.

▴ Photo 87. Roseola skin rash.
Used with permission from Ross Lab. Columbus, Ohio, USA
Parents Should Be Half-Doctors Too – Encyclopedia of Pediatric Home Nursing

● This is an infectious disease that commonly occurs in infants and young children aged 3 months to 3 years.

● A high fever of around 39-40°C (100-104°F) persists for 1-4 days. As soon as the fever subsides, a red, erythematous, or papular rash similar to measles or rubella may appear.
● This rash typically begins on the trunk and spreads to the face, neck, and limbs.
● The rash progresses for 1-2 days and then fades naturally.
● A febrile convulsion may occur before the rash appears.
● Because there are no specific symptoms or signs on examination, a definitive diagnosis is often difficult.
● The patient may be quite irritable from the onset until the fever subsides.
● A diagnosis is made by combining the medical history, symptoms, and physical findings, and fever is treated with Tylenol. Source and References: Pediatric Skin Rash, Pediatric Annals, October 2010

10. Erythema infectiosum (Fifth Disease)

● This is a viral infection caused by human parvovirus B19.
● This disease is called fifth disease.
● Mild symptoms such as fever, headache, chills, muscle pain, and malaise may occur.
● Initially, the cheeks become flushed, followed by erythematous, papular, reticulate, or lacy macules on the shoulders and upper arms.
● The rash may last for 2-3 weeks.
● Joint pain occurs in approximately 10% of cases.
● If a pregnant woman is infected with this virus, the fetus may develop severe anemia or hydrops fetalis.
● Diagnosis is based on a comprehensive review of medical history, symptoms, signs, and physical findings.
● Treatment is symptomatic. Source and References: Pediatric Skin Rashes, Pediatric Annals, October 2010

11. Chickenpox
Chickenpox (Varicella) 33

▴ Photo 91. Chickenpox skin rash.
Copyright ⓒ 2012 John Sangwon Lee, MD. FAAP

▴ Photo 90. Chickenpox skin rash.
Copyright ⓒ 2012 John Sangwon Lee, MD. FAAP

● Chickenpox is a viral infection caused by the varicella-zoster virus.
● The disease develops after an incubation period of 10 to 20 days.
● Systemic symptoms such as low-grade to high-grade fever and headache may occur.
● Initially, erythematous macules appear on the trunk, which then transform into papular macules. The chickenpox rash then progresses in a sequence of vesicles, pustules, and crusts.
● Various types of chickenpox rashes can be seen simultaneously. A unique characteristic of chickenpox is that it begins on the trunk and then spreads to the arms, legs, and face.

● A rash appears for 5 to 10 days and then heals with a crust.
● A skin rash is usually accompanied by symptoms such as itching and malaise.
● A light scar may form on the skin after the rash has completely healed.
● Natural chickenpox caused by infection with the natural varicella virus,
● Vaccinated chickenpox caused by infection with the live varicella virus contained in the varicella vaccine,
● Natural chickenpox after vaccination, which occurs after vaccination, occurs when the body has sufficient varicella immunity to prevent wild chickenpox for a period of time and then naturally decreases as the antibody concentration decreases.
● The symptoms and signs of this type of chickenpox differ from the varicella rash.
● A diagnosis is made based on a comprehensive review of medical history, symptoms, and physical findings.
● Tylenol is used to reduce fever, pain, and inflammation.

● Treat with Acyclovir (Zovirax) as needed.
Source and Reference: Pediatric Skin Rash, Pediatric Annals, October 2010

▴ Photo 92. Shingles rash.
Copyright ⓒ 2012 John Sangwon Lee, M.D. FAAP

▴ Photo 93. Shingles rash.
Copyright ⓒ 2012 John Sangwon Lee, M.D. FAAP

12. Shingles
Herpes Zoster (Shingles)
See Chickenpox and Shingles
● This is a varicella-zoster neurodermatosis (NSRD) caused by latent varicella-zoster virus infection of the dermatomes and cranial or peripheral nerves.
● This NSRD is called shingles, not chickenpox.
● Because shingles develops in the dermatomes supplied by the nerves, shingles is limited to a specific area of ​​the skin.

● The area where shingles will appear can be very painful before it appears, and it can also be painful after the rash appears.
● The rash, which includes erythema, papules, and blisters, usually appears in specific dermatomes along the peripheral nerve distribution on one side of the body.
● It usually resolves naturally after 8 to 12 days.
● Pain can be relieved with pain relievers such as Tylenol.
● Oral Acyclovir can be used for treatment. This medication is poorly absorbed from the gastrointestinal tract, which can cause treatment problems in children.
● Adults can treat shingles with Famciclovir or Valacyclovir Hydrochloride.
● Children with shingles are selectively treated with antiviral medications.
● If a child with shingles is immunocompromised, treatment can be administered with intravenous Acyclovir. See www.dermatlas.org and APP news. Source and References: Pediatric Skin Rashes, Pediatric Annals, October 2010

13. Herpes Simplex Infection
See Herpes Simplex Gingivostomatitis.

▴ Figure 95. Gingivostomatitis and dermatitis due to herpes simplex infection.
Copyright ⓒ 2012 John Sangwon Lee,M,D. FAAP

▴ Figure 96. Dermatitis due to herpes simplex infection.
Copyright ⓒ 2012 John Sangwon Lee, M.D. FAAP

● Herpes simplex virus type 1 infection can cause a rash, including red spots, papules, and blisters, on the lips, face, arms, legs, trunk, fingers, or skin around the eyes.
● Fever may be absent or present.
● High fever is common with herpes simplex virus type 1 gingivostomatitis.

● Type 1 herpes simplex gingivostomatitis resolves naturally in about 7 to 10 days.
● Around the time this condition resolves, a herpesvirus skin rash may appear around the lower lip.
● Only herpes simplex dermatitis may occur, not gingivostomatitis.
● Type 2 herpes infection can spread to the external genital skin, causing vaginitis and male external genital herpes dermatitis.
● Diagnosis is usually based on medical history, symptoms, and physical examination findings.
● Symptomatic treatment is followed by oral Acyclovir.
● Herpes simplex infection (herpes simplex infection)
Source and reference: Pediatric skin rashes, Pediatric annals, October 2010

CMV (Mononucleosis exanthem)

● Mononucleosis can occur due to cytomegalovirus infection.
● The symptoms are similar to those of infectious mononucleosis caused by a viral infection, including a skin rash.
● A fever may persist for 1 to 5 weeks, and treatment with Ampicillin or Amoxicillin can lead to a skin rash in 80 to 100% of cases.
● A mono test for this disease will often be negative.
● Diagnosis is made based on a comprehensive review of medical history, symptoms, and physical findings, and symptomatic treatment is recommended.
Source and References: Pediatric Skin Rash, Pediatric Annals, October 2010

15. Hand-Foot-and-Mouth Disease
See Hand-Foot-and-Mouth Disease

▴ Photo 99. Palmar dermatitis and palatal rash caused by hand-foot-and-mouth disease. Copyright ⓒ 2012 John Sangwon Lee, MD. FAAP

● This is a viral infection caused by coxsackievirus or echovirus infection.
● It may be accompanied by systemic symptoms such as low-grade fever, loss of appetite, sore throat, malaise, and abdominal pain.
● These symptoms persist for 2-3 days, followed by the appearance of erythematous, papular rashes measuring 1-3 mm on the palms, soles, sides of the hands or feet, buttocks, and abdomen.
● The rash develops into blisters measuring 3-7 mm in diameter.
● The blisters may develop ulcers.
● The rash resolves spontaneously after 2-7 days.
● A similar rash may appear on the soft palate, hard palate, gums, tongue, and oral mucosa. Up to one-third of children develop this rash on their hands and feet.

● Diagnosis is made based on a comprehensive review of medical history, symptoms, and physical examination findings, and fever is treated with Tylenol.
Source and References: Pediatric Skin Rash, Pediatric Annals, October 2010

16. Skin Rash Caused by Adenovirus Infection
Adenoviral Exanthem
See Adenovirus and Infectious Diseases
● Adenovirus infection can cause rhinitis, pharyngitis, upper respiratory tract infection, keratoconjunctivitis, or pneumonia. It can also cause a skin rash or a spotty hemorrhagic spot similar to measles.
● Symptoms and signs such as enlarged cervical lymph nodes, fever, runny nose, and malaise can occur, and sometimes symptoms similar to a cold can occur.
● It is more common in spring and summer.
● Diagnosis is usually based on a comprehensive review of medical history, symptoms, and physical examination findings.
● A definitive diagnosis can be made by swabbing mucus from the conjunctiva or pharyngeal mucosa and performing a virus culture.
● Symptomatic treatment is indicated. Source and References: Pediatric Skin Rash, Pediatric Annals, October 2010

17. Skin Rash Caused by Enteroviral Infections
Enteroviral exanthem

▴ Photo 100. Skin rash caused by enteroviral infection.
Copyright ⓒ 2012 John Sangwon Lee, M.D. FAAP

● Enteroviruses are classified into Coxsackie A1-24, Coxsackie B1-6, Echo 1-34, and Entero 68-72.
● Skin rashes are common in children with enterovirus infections caused by one of these virus species.
● Enterovirus infections are more common in the summer and fall.
● Symptoms of enterovirus infections include fever, malaise, upper respiratory tract infection, vomiting, diarrhea, and abdominal pain. ● Rarely, nonbacterial meningitis may occur.
● An erythematous macular or papular rash similar to the skin rash associated with rubella or scarlet fever may occur.
● Occasionally, blisters, urticaria, or petechial hemorrhagic spots may develop.
● The erythematous macular and papular rash initially appears on the face and may spread to the entire body.
● Diagnosis is based on a comprehensive review of medical history, symptoms, and physical examination findings, and symptomatic treatment is administered.
● See Hand, Foot, and Mouth Disease. Source and References: Pediatric Skin Rash, Pediatric Annals, October 2010

18. Skin Rash Caused by Rotavirus Infection
Rotaviral Exanthem
● See Infectious Diseases Caused by Rotavirus.
● Symptoms of gastroenteritis caused by rotavirus infection may include diarrhea, fever, vomiting, and dehydration. Sometimes, erythematous or papular rashes, 2-3 mm in diameter, similar to a rubella rash, begin on the trunk and spread to the face and extremities.
● This rash naturally resolves after 2-3 days.
● Diagnosis and symptomatic treatment are based on a comprehensive review of symptoms, medical history, and physical examination findings.
● [Parents Should Become Half-Doctors Too – Encyclopedia of Pediatric Home Nursing] – Volume 9, Pediatric and Adolescent Digestive Diseases – Infectious Diseases Caused by Rotavirus.
Source and References: Pediatric Skin Rashes, Pediatric Annals, October 2010

19. Pityriasis Rosea

▴ Photo 101. Skin rash caused by pityriasis rosea.
Copyright ⓒ 2012 John Sangwon Lee, MD.FAAP

Pityriasis rosea is an acute, benign skin condition caused by a viral infection. ● It occurs more frequently in adolescents and young adults, but can also occur in infants and toddlers after 8 months of age.
● Mild symptoms such as headache, fatigue, sore throat, enlarged lymph nodes, low-grade fever, or itching may occur.
● Initially, one or two erythematous papules appear on the chest, extremities, and neck. They are followed by numerous oval-shaped erythematous or papular erythema, measuring 2-5 cm in diameter, spreading to the chest, extremities, and neck.
● However, the scalp or face is not affected.
● The center of the erythema is flat and may be red or brown with scales.
● It resolves spontaneously after 6-10 weeks.
● The distribution of pityriasis rosea over the entire back may resemble an upside-down Christmas tree. The distribution of this skin rash can sometimes be diagnosed visually.
● The diagnosis is made by combining the medical history, symptoms, and physical examination findings.

● Fever and itching can be treated with Tylenol and steroid ointment.
● See Pityriasis Rosea.
Source and References: Pediatric Skin Rashes, Pediatric Annals, October 2010

20. Erythema Multiforme and Stevens-Johnson Syndrome
Erythema multiforme and Stevens-Johnson’s syndrome
See Steven-Johnson Syndrome, Erythema Multiforme, and Toxic Epidermal Necrolysis (Scalded Skin Syndrome).

▴ Photo 103. Erythema multiforme on the knee and leg.
Copyrightⓒ 2012 John Sangwon Lee, MD. FAAP

6666

▴ Photo 108. Skin rash due to Gianotti-Crusty syndrome
Source: www.dermatlas.org

29. When treating a non-febrile illness with medication, the medication can cause a skin rash and fever as a side effect. Similarly, when treating an infectious disease with medication, the medication can cause a skin rash as a side effect and the infection can cause a fever.
[Parents Should Become Half-Doctors Too – Encyclopedia of Pediatric Home Nursing] – Volume 15, Pediatric and Adolescent Allergies and Immune Diseases – Drug Allergy Diseases and Drug Side Effects. Source and References: Pediatric Skin Rash, Pediatric Annals, October 2010

30. Other illnesses can cause a skin rash with a fever.

The following is an example of an online pediatric and adolescent health consultation Q&A regarding “Skin rash with fever, heat rash, and roseola.”

Q&A. Skin Rash with Fever, Rosacea
Q
I’ve had a fever for four days, but the hospital says there’s nothing wrong. Why does my child keep having a fever? I’m also getting red spots on my body… Should I get a comprehensive examination at a larger hospital?
My child is 13 months old.
A.
Kyungsook
● Hello. Thank you for your question. It’s a good question.
● The more information we have about your child’s age, gender, past medical history, family medical history, physical findings, and clinical tests, the more helpful it is to answer your question. I will answer based on the information you provided.
● There are many causes of fever.
● I suspect that my child has roseola.
● If your child is still undiagnosed and sick, please get re-evaluated at a pediatric clinic and treat accordingly.
● [Parents Should Become Half-Doctors Too – Encyclopedia of Pediatric and Family Nursing] – Volume 7 Pediatric and Adolescent Infectious Diseases – Rosacea, Skin Rash (Fever), and Diseases Causing Fever. Please refer to Volume 22, Child and Adolescent Childcare and Home Care – Fever, etc. If you have any further questions, please contact us again. Thank you. Sincerely, Sangwon Lee

The following is an example of a Q&A session for the online Pediatric and Adolescent Health Counseling service regarding “skin rash.”
Q&A. Skin Rash

Q
My son is 5 years old. Four days ago, he developed a bumpy rash (red) around his face, nose, and chin. He said it didn’t itch. Then, the rash spread from his armpits to his stomach and feet (like a measles rash). There was no rash on his arms or legs. Two nights ago, he had a slight fever (37.3 degrees Celsius). He hasn’t had a fever since then. He has no other symptoms. He’s as normal as usual. I’m just observing him to see if it’s a viral infection, but I don’t have time to go to the hospital due to work, so I’m asking. I know you’re busy, but I appreciate your response. Thank you.
A.
Okja
● Hello. Thank you for your question.

● Ideally, diagnosis and treatment should be based on a comprehensive analysis of age, gender, past and present family medical history, symptoms and signs, physical examination findings, and appropriate clinical tests. However, I will provide an answer based on limited information.
● Measles,
● Scarlet fever,
● Rubella,
● Rosacea,
● Infectious erythema,
● Mono (infectious mononucleosis),
● Coxsackievirus infection,
● Echovirus infection,
● Adenovirus infection, etc. Skin rashes can be caused by various diseases, such as drug eruptions and Kawasaki disease.
● Symptoms and signs vary slightly depending on the disease, and various types of skin rashes can occur accordingly.
● I cannot definitively tell you the cause of the rash.
● A body temperature of 37.3℃ is considered normal.
● Please consult a pediatrician as soon as possible for a diagnosis and consultation regarding this matter.

● [Parents Should Become Doctors Too – Pediatric Encyclopedia] – Please refer to Volume 7, Pediatric and Adolescent Infectious Diseases – Scarlet Fever, Measles, Rubella, etc. Also, please refer to p. 00, Skin Rash and Skin Rash with Fever. Please visit again if you have any further questions. Thank you. Dr. Sangwon Lee

Greetings from my blog, http://blog.naver.com/drsangwonlee. The above article is from www.koreapediatrics.com, “Parents Should Become Half-Doctors Too.”
Easy-to-understand, practical, and comprehensive, up-to-date information.
Parents Should Become Half-Doctors Too.
This article was copied from “Skin Diseases in Children and Adolescents (Ages 1-18)”. Written and published by Dr. Sangwon Lee.
1. http://www.koreapediatrics.com/Parents Should Become Half-Doctors Too – Approximately 20,000 pages. Title: 13412. Published in 2013. Pediatrics website operated by Dr. Sangwon Lee.
2. Encyclopedia of Pediatric Family Medicine – 618 pages, published in 1988.
3. Encyclopedia of Pediatric Family Nursing – Parents Should Become Half-Doctors Too – 1076 pages, published by Cheongmungak in 1998.
4. Growth and Development of Newborns, Infants, Toddlers, School-Age Children, and Adolescents. Parenting – 623 pages, published by Good Land in 2014
5. Healthy Growth and Development in Newborns: Diseases, 610 pages, published by Good Land in 2014
6. Breastfeeding: Reasons for Breastfeeding, 308 pages, published by Good Land in 2014
7. Epilepsy in Children and Adolescents: 100 Questions and Answers on Epilepsy, 240 pages, published by Good Land in 2015
8. From Pregnancy to Newborn Care, approximately 300 pages, published by Cheongmun-gak in 1998
9. Raising Your Son or Daughter with Love, 210 pages, translated by Ross Campbell, MD, a world-renowned masterpiece, published by Seomun-dang in 1988
11. Drugs and Children, approximately 200 pages, published by Yangseo-gak in 1988
12. Raising Your Son or Daughter with Unconditional Love, and Character Education, This Way, published by Yangseo-gak in 2016, 647 pages
13. https://www.flickr.com/people/drleesangwon
14. http://blog.naver.com/drsangwonlee
15. https://www.facebook.com/drleesangwon
16. Pediatric by Norekyokorea.net
17. Most of the other postings are from www.koreapediatrics.com. Although they are professional, I believe they will be very helpful in raising children and adolescents. However, the information here cannot replace the information and treatment you get from your doctor. www.koreapediatrics.com Parents Should Become Half-Doctors, Too Author: Sangwon Lee, Yonsei University College of Medicine
Volunteered for two years in a village without doctors and worked as a military doctor in the Republic of Korea for three years
Residency in Pediatrics at UCONN School of Medicine and Yale University School of Medicine in Connecticut, USA
American Pediatrician, Korean Pediatrician
American Top Pediatrician 2002-2005
Connecticut State Medical License #016370
Korean Medical License #7794
Copyrightⓒ 2017 John Sangwon Lee, MD.FAAP
■ Character Education – Raise Your Son or Daughter with Unconditional, True Love, and this is how to Learn Character Education, see Yangseo-gak

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