Erythematous Rashes - THE ALGORITHMIC APPROACH
Characterized by diffuse redness of the skin due to
capillary congestion, erythematous rashes (Figure 2,
page 9) are differentiated from other rashes based
on the presence or absence of fever and the Nikolsky
sign. If these factors are present, the diagnosis is
narrowed substantially, usually to TEN in adults and
staphylococcal scalded skin syndrome (SSS) in infants
and young children. If fever is present without
the Nikolsky sign, the differential diagnosis includes
Kawasaki disease, scarlet fever, and toxic shock syndrome
(TSS). Those patients with an erythematous
rash but without a fever or Nikolsky sign may be
having an anaphylactic reaction or an exposure reaction
to scombroid or alcohol.
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