Online Canadian Pharmacy Blog

Okay, next are winter exanthems and in the wintertime a lot of nondescript rashes, erythematous, maculopapular, discreet. Last one or two days. It turns out that with common respiratory viruses that we talked about – parainfluenza, RSV, rhinovirus and influenza viruses – all are associated with exanthem in 5-10% of the time. This was demonstrated by a great general practitioner in England by the name of Hope Simpson many many years ago. What’s important about this is that these are children who have respiratory symptoms and frequently have been put on antibiotics for otitis and therefore they will have this rash for one or two days after they were put on amoxicillin online pharmacy, in particular. I think the important thing is that you don’t want to automatically label these children as penicillin allergic. Wait a day or two because these rashes don’t last. The rash will go away and you’ve continued your antibiotic and you haven’t labeled then penicillin-allergic.
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Lastly are adenoviruses. Adenoviruses give a variety of rashes. Usually are more severe than enteroviruses but can look like roseola, can have a measles-like rash. Erythema multiforme and Stevens-Johnson syndrome.
How do you approach diagnosis of rashes? This is not the way, and I’ve already told you why, because you don’t want a situation like the obstetrician that exposed 240 pregnant women. This is another approach. But the way to approach it, and the dermatologists always kill me because they go and pronounce something, but really if you go through this and just looking at the rashes is only part of it. Find out exposure. Classic exanthems have a high clinical expression rate, so they should have had a history. For example, measles. There should be a case discernible. Varicella the same. Season; classic exanthems in the winter and spring, enteroviruses in the summer. Incubation period; short with enteroviruses, long with classics. Age; today most cases of rubella and measles will be seen in adults. Hopefully in a few years that will be true of varicella as well, because children should be being vaccinated. Relation of rash to fever and roseola. Adenopathy for rubella type distribution and other laboratory tests. I didn’t say much about them but workup, when it’s appropriate, for viruses, Mycoplasma, Epstein-Barr virus, infectious mono can have rash. So in general, a general workup rather than just looking at the rash.
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