Background

An exanthem is a skin eruption occurring as a symptom of a general disease, usually an infectious process. The following tables list several clinical differential diagnoses that should be considered when encountering a patient with these symptoms.

EXANTHEMATOUS ILLNESSES WITH PETECHIAE

SKIN PETECHIAE (EXANTHEM)	Enterovirus EBV CMV Meningococcemia Gonococcemia (pustules more common) Rocky Mountain spotted fever Henoch-Schonlein purpura Rat bite fever Ehrlichiosis Dengue fever Leptospirosis
ORAL MUCOSAL PETECHIAE (ENANTHEM)	GABHS Rubella EBV Arcanobacterium haemolyticum

RASH INVOLVING THE HANDS AND FEET

BACTERIAL	Rocky Mountain Spotted Fever
VIRAL	Hand-Foot-Mouth disease Papular-purpuric gloves and socks syndrome (Parvovirus B19 infection)
OTHER	Kawasaki's disease
NON-INFECTIOUS	Erythema multiforme

PHARYNGITIS AND RASH IN YOUNG ADULTS

BACTERIAL	GABHS Arcanobacterium haemolyticum Staphylococcus aureus Secondary syphilis Gonorrhea
VIRAL	EBV CMV Enterovirus

Fitzpatrick's Dermatology in General Medicine. Fifth Edition. McGraw-Hill. 1999.

Last Updated 1/1/2001

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