8yrs/m with h/o fever and rash -days with itching nd +ve family history Dx Rx



It is not chicken pox If it is Active disease , papules, vescles and pustules are seen simultaneously and as the rash appears in crops certainly different stages of evolution of rash will be present. If at the end stage then the vesiculo pustules dry up and scabs are seen. Where are the scabs? The morphology of lesions show an erthymatous base on which a vascle has dried up. The oral lesions being enanthema is ruled out as exenthema itself is ruled out. The lip leion is not apthousulcer as ther is no inflamatory halo nor necrotic base. Note the erythema of gingia ( lower)could the mucosal lesions due to HSV 1 (FEBILE SORES). NO THEY WILL BE IN GROUPS AND EVEN IF MERGED IT WILL SHOW TH SCALLOPED BORDER OF INDIVIDUAL LESIONS. IF , FEVER AND FEBRILE SORE- THE EXAMTHEMATOUS RASH AN BE CONSIDERED AS HSV 1 is still the leading cause.of EMF.BUT IT IS ALSO RULED OUT. SO WHAT IS LEFT THE TOTAL FINDINGS ARE EXPLAINED BY CONSIDRING " ERTHMA MULTIFOME" PROBABLY DRUG INDUCED OR THE INFECTION ITSELF . THE LIST OF .INFECTIONS CAUSING EMF IS SHORT WHICH COULD BE CORRELATED WITH ACTUAL CLINICAL FEATURES OTHER THAN RASH. IN THE ABSCENCE IT IS "DRUG INDU ED" IDENTIFY AND STOP OFFENDING DRUG. THIS IS MY BEST BET. ANY DOUBT - PL DISCUSS. REGARDS TO ALL.

Points taken sir. Sir with all do respect if i may share the view little in contrast to E.M. then sir the history states that other family members are also having similar complaints...so drug induced is less likely...anyways it is more common with infections. But sir again family member also developing E.M. is a liitle unusual, though it may happen. And sir clinically target lesions are also not there which are characteristic for E.M.which usually start from distal extremities.... Sir, please correct me wherever i am wrong.. My response is with utmost respect towards you sir...thank you.

Dr Mayur.. The exanthem was not varicella as per arguments advanced. Then what aternative explains both anathema and exanthema. Hepes type 1 is enough to account for oral esions but the cutsneous ledions just don't dry up like in picture. Grouping is lacking. It is the commonest cause of EMF which can explain both ananthema and exanthema. HSV is already excuded. Hence suspecian is diected to a possible drug effect. Some target like lesions ore seen (by my eyes ( and beware ne's eyes can deceive), The cntral dried up lesion is taken as bulls eye and surrounding erythema as target board. The same looks like papular urticaria which cannot explain the total pucture. Clinical diagnosis is a compromise and is valid as long as it could be reasonably substantiated. U can take it as a DD atleast and strive to find a better diagnosis. Rrasoned and seasoned arguments r always welcome. The diagnosis at the worst or best saves the shot gun asssults of therapies of dubious value. Y made a point that EMF lesions r chatacteristiclly assume target shape on the back of hands (dorsal aspect) and then....whereis the puc either to substantiate or deny the diagnosis. As seen from the pic the skin lesions t involuting and left to them they will be happy to disappear, but the question is will we..?. I like discussion and happy to lose an argument if I can learn something. I am senior learner than a teacher. Pl try and improve the diagnosis Dr zmayur and all co curofians.

Chickenpox TREATMENT ACYCLOVIR Atarax Histocalamine lotion Stomacare mouth lotion

As it symptoms Dx _ Chickenpox. . Rx _ ""Acyclovir,"" an antiviral medication, is licensed for treatment of chickenpox. The medication works best if it is given within the first 24 hours after the rash starts. Other antiviral medications that may also work against chickenpox include valacyclovir and famciclovir. Use non-aspirin medications, such as acetaminophen, to relieve fever from chickenpox. Do not use aspirin or aspirin-containing products to relieve fever from chickenpox. The use of aspirin in children with chickenpox has been associated with Reye’s syndrome, a severe disease that affects the liver and brain and can cause death.

Varicella zoster

Scarlet fever check blood tests platelet count& etc Rx tab azithromycin tab calpal 250 mg TID syrup polybion Bd syrup Atarax,Dosetil lotion L/a & other supportive measure


Varicella zoster

Stomatitis. Zytee Lotion Locally. Inj Polybion IM 5 days.

EM / Chicken pox (?)

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