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Name the triad of Rocky Mountain spotted fever.
1. A petechial rash, though it can be simply macular initially.
2. Fever
3. Headache
When do the "spots" of Rocky Mountain spotted fever appear in relation to the fever?
The rash will appear about 2 days after the onset of fever.
What syndrome appearing out of its proper time should be considered very early Rocky Mountain Spotted fever until proven otherwise?
"Summertime flu"
Name 4 areas where unilateral laterothoracic exanthem might typically first appear. What feature do these areas all share?
These start on one side of the body only:
1. Axillum
2. Groin
3. Inner aspect upper arm
4. Lateral trunk
Upon which 4 places on the body should one never expect to find lesions of unilateral laterothoracic exanthem?
1. Face
2. Palms
3. Soles
4. Mucus membranes
1. What is the primary lesion of unilateral laterothoracic exanthem?
2. As it evolves and spreads, what might it also resemble over time? (3 possibilities)
3. As they resolve and regress, how might they look?
1. Small erythematous papules with a surrounding pale halo.
2. As they spread and coalesce, they can appear:
a. Eczematoid
b. Morbilliform
c. Reticuloform
3. Regressing lesions form dusky grey centers that later still form a bran-like scale.
What are the 4 clinical stages of unilateral laterothoracic exanthem?
1. Eczematoid
2. Coalescence: the lesions grow and extend on the trunk, even spreading to the other side.
3. Regression: older lesions develop a dark grey center.
4. As the lesions fade, a fine "bran-like" desquamation can be found.
How long can the rash of unilateral laterothoracic exanthem persist before disappearing for good?
Up to 8 weeks
What is the "season" for unilateral laterothoracic exanthem?
Winter and spring.
What causes unilateral laterothoracic exanthem?
No one knows.
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