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| − | A '''maculopapular rash''' is a type of rash characterized by a flat, red area on the skin that is covered with small confluent bumps. It may only appear red in lighter-skinned people. The term "maculopapular" is a compound: ''macules'' are small, flat discolored spots on the surface of the skin; and ''papules'' are small, raised bumps. It is also described as erythematous, '''or red.''' | + | A '''maculopapular rash''' is a type of rash characterized by internal medicine physicians as macular and/or papular, possibly rash-like, and involving the skin. To any internist and hospitalist, the differential diagnosis for a '''maculopapular rash''' includes nearly every skin condition and infection known to man because they are all maculopapular and as a result needs dermatology involved. To emphasize this point, internal medicine physicians will repeatedly say maculopapular in increasingly louder tones, causing any dermatologist's eardrums to perforate and bleed. When this happens, please escort the dermatologist away and if needed get consent for blood transfusion. |
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| − | This type of rash is common in several diseases and medical conditions, including scarlet fever, measles, Ebola virus disease, rubella, secondary syphilis (Congenital syphilis, which is asymptomatic, the newborn may present this type of rash), erythrovirus (parvovirus B19), chikungunya (alphavirus), and heat rash. It is also a common manifestation of a skin reaction to the antibiotic amoxicillin or chemotherapy drugs.<ref>[http://www.chemocare.com/managing/allergic_reactions_and_chemotherapy.asp Managing allergic reactions to chemotherapy, chemocare.com]</ref> Cutaneous infiltration of leukemic cells may also have this appearance. Maculopapular rash is seen in graft-versus-host disease (GVHD) developed after a hematopoietic stem cell transplant (bone marrow transplant), which can be seen within one week or several weeks after the transplant. In the case of GVHD, the maculopapular rash may progress to a condition similar to toxic epidermal necrolysis.<ref>[http://emedicine.medscape.com/article/1050580-overview Graft Versus Host Disease, emedicine.com]</ref> In addition, this is the type of rash that some patients presenting with Ebola virus hemorrhagic (EBO-Z) fever will reveal but can be hard to see on dark skin people.<ref>Stanford University 1997, Accessed Oct. 2014 https://web.stanford.edu/group/virus/filo/humandiseases.html</ref> It is also seen in patients with Marburg hemorrhagic fever, a filovirus not unlike Ebola.
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| − | This type of rash can be as a result of large doses of niacin or no-flush niacin (2000 – 2500 mg), used for the management of low HDL cholesterol.
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| − | This type of rash can also be a symptom of Sea bather's eruption. This stinging, pruritic, maculopapular rash affects swimmers in some Atlantic locales (e.g., Florida, Caribbean, Long Island). It is caused by hypersensitivity to stings from the larvae of the sea anemone (e.g., ''Edwardsiella|Edwardsiella lineate'') or the thimble jellyfish (''Linuche|Linuche unguiculata''). The rash appears where the bathing suit contacts the skin.<ref>[http://www.merckmanuals.com/professional/injuries_poisoning/bites_and_stings/marine_bites_and_stings.html Overview of Marine Bites and Stings, by Robert A. Barish, MD, MBA, Thomas Arnold, MD], Merck Manual</ref>
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| − | This type of rash can also be a symptom of acute arsenic intoxication, appearing 2 weeks later. <ref>[http://www.hc-sc.gc.ca/ewh-semt/alt_formats/hecs-sesc/pdf/pubs/water-eau/arsenic/arsenic-eng.pdf]</ref>
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| − | ==References==
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Revision as of 15:00, 15 July 2016
A maculopapular rash is a type of rash characterized by internal medicine physicians as macular and/or papular, possibly rash-like, and involving the skin. To any internist and hospitalist, the differential diagnosis for a maculopapular rash includes nearly every skin condition and infection known to man because they are all maculopapular and as a result needs dermatology involved. To emphasize this point, internal medicine physicians will repeatedly say maculopapular in increasingly louder tones, causing any dermatologist's eardrums to perforate and bleed. When this happens, please escort the dermatologist away and if needed get consent for blood transfusion.
