Exanthematous diseases are infectious diseases characterized by the appearance of a rash, that is, mostly generalized skin alterations consisting of repetitive lesions. In some diseases, the skin lesion remains confined to certain parts of the body.
The most common exanthematous diseases in children and at a young age are: measles, chicken pox, rubella, scarlet fever, fifth and sixth diseases, hands feet mouth, pityriasis rosea.
Rashes must be distinguished from skin lesions that develop as a result of toxic or allergic states.
The most common diseases that can be associated with a rash are allergies, various infectious diseases, both viral and bacterial, and some autoimmune diseases.Symptoms
Usually, in exanthematous diseases there is an interval of time between the onset of symptoms and the appearance of the exanthema but people can be contagious even before skin changes appear.
The main symptoms that occur in exanthematous diseases are fever, chills, muscle aches, itching, fatigue. Sometimes, in addition to the classic symptoms, sore throat, cough, runny nose, red eyes and conjunctivitis, headache, abdominal pain, diarrhea, feeling of general malaise, loss of appetite, tiredness and irritability may also be present.
The skin lesions that make up the rashes are:
- erythema, redness of the skin that can be confined to a specific area or spread to multiple parts of the body
- stain, altered and limited coloration of the skin
- macula, patchy change in the skin
- papule, solid skin pad
- nodule, similar to the papule but larger in size
- plate, uneven skin relief
- vesicle, a small, fluid-filled blister that forms under a thin layer of skin containing serum or blood
- bubble, like the vesicle but larger in size
- pustule, like the vesicle but contains pus
- scale, flaking of the skin
- wheal, rounded relief of the skin
- petecchia, red point lesion
- bruising or bruising, bright red or dark red-purplish spot
The most common exanthematous diseases are due to infection by viruses and bacteria, but can also occur as a result of fungal infections. They are highly contagious diseases and are widespread mostly in the winter and spring months. Infections are usually transmitted through droplets spread in the air (droplets or aerosols) through coughing, laughter or sneezing from infected people. In addition, transmission can occur through direct contact with the secretions of the nose and throat or with the fluid contained in the vesicles, when present.
The most common exanthematous diseases due to viral infections are:
- hand-foot-mouth disease
- herpes simplex
The most frequent exanthematous diseases due to bacterial infections are:
- scarlet fever
- bacterial endocarditis
- button fever and other rickettsioses
- typhoid fever
- pseudomonas aeruginosa sepsis
Rash diseases due to fungal infections are less common and include, for example, candidiasis.Diagnosis
The diagnosis of an exanthematous disease takes into account clinical and epidemiological aspects. Clinical aspects consider the morphological characteristics of the lesions; the manner of appearance and extension; the presence of exanthema in the mucous membranes; the clinical manifestations that precede or accompany the exanthema. The epidemiological aspects take into account the age of the patient; the possible exposure to other subjects with exanthematous diseases; previous exanthematous diseases; previous vaccinations; taking medications. For some exanthematous pathologies, blood tests can also be performed to confirm their presence.Therapy
There are no specific drugs for the treatment of exanthematous virus diseases.
Therapy usually focuses on "relieving symptoms and involves the use of:
- paracetamol, to lower fever
- antihistamines, to relieve any itching
- prepared for local use, to relieve itching
In case of scarlet fever or concomitant bacterial infections, antibiotics (ampicillin or cephalosporins) are used instead.Prevention
Exanthematous diseases cannot be contracted a second time because after healing you are protected for life. Scarlet fever, because it is caused by a bacterium, and chicken pox are exceptions. The virus (herpes zoster) that causes chickenpox, in fact, can remain hidden in the body even after healing and, in particular situations (stress or illness), can return and manifest itself even after years, giving rise to the "Fire of Sant 'Antonio', a very painful condition in which only one nerve is usually affected with the appearance of skin blisters along its course.
A fundamental recommendation is to submit children to the vaccination program: today there is an effective and safe vaccine against measles, rubella and chicken pox. There are no vaccines for scarlet fever.Complications
Exanthematous diseases can cause complications that are rare but can also be serious and permanent (read the Hoax).
Complications are mainly due to the development of bacterial infections and may include otitis, laryngitis, diarrhea, pneumonia, liver or kidney or heart damage, or encephalitis (inflammation of the brain). They occur more often in infants, malnourished children or in people with a weakened or compromised body's defense system (immune system).
Some exanthematous diseases, such as chicken pox, rubella and more rarely the fifth disease, if contracted in the first trimesters of pregnancy can cause serious problems for the fetus that can even lead to spontaneous abortion. In addition, chickenpox can be transmitted to the fetus at the time of delivery, causing a severe form of the disease in the newborn; rubella can also cause serious organ problems after birth.Bibliography
University of Perugia. Faculty of Medicine and Surgery. Master's degree course in Medicine and Surgery. Exanthematous diseases
University of Bari "Aldo Moro". Degree course in Nursing "G. Panico". The rashIn-depth link
Mayo Clinic. Rubella (English)
Mayo Clinic. Measles (English)
Mayo Clinic. Scarlet fever (English)
Mayo Clinic. Chickenpox (English)
EpiCentro (ISS). Chickenpox
EpiCentro (ISS). Rubella
EpiCentro (ISS). Measles