Updated: 1/9/2018

Microbiology of Rashes

Review Topic
 Bugs Causing Rashes
Disease Rash Progression
Other Symptoms
Streptococcus pyogenes Scarlet fever Erythematous, sandpaper-like with numerous papules
Groin/axilla → trunk and extremities, sparing palms and soles. Rash is folllowed by desquamation.
Fever, sore throat, nausea
Staphylococcus aureus Toxic Shock Syndrome Sunburn-like (diffuse, erythematous, macular) with desquamation on palms and soles Trunk and neck → extremities High fever and severe systemic illness
Rickettsia rickettsii RMSF Blanching, erythematous macules Petechial Wrists/ankles → trunk. Rash then appears in later stage disease on the palms and soles Fever, headache
Treponema pallidum Secondary syphilis Copper-colored maculopapular, including palms and soles

Condylomata lata
Alopecia (patchy)
Constitutional symptoms

Borrelia burgdorferi Lyme disease Erythema chronicum migrans (expanding target-shaped red rash) Expanding circle Flu-like symptoms
Coxsackievirus type A Hand, foot, and mouth Vesicular Palms and soles only Ulcers in mouth
Rubella virus German measles (Rubella) Maculopapular Head → body. Lasts 3 days. Postauricular lymphadenopathy. Congenital rubella in fetus.
Rubeola virus Measles Maculopapular Head → entire body. Becomes confluent as it spreads downward. 3 C's, Koplik spots
Mumps virus Mumps None None Parotitis, orchitis
VZV Chickenpox Asynchronous Trunk → face/extremities Fever, pharyngitis, malaise
HHV-6 Roseola infantum
Blanching, maculopapular, occurs after fever Neck/trunk → face/extremities
High fever followed by rash (separatd temporally).  Affects infants
Parvovirus B19 Erythema infectiosum "Slapped cheek" Face → body Hydrops fetalis in pregnant women
  • Other possible causes of palm and sole rash include:
    • Graft Versus Host Disease
    • Contact dermatitis
    • Endocarditis
    • Kawasaki's Disease
    • Rubella
    • Neisseria meningitidis (disseminated meningococcemia)
    • Parovirus B19 (papular-purpuric gloves and socks syndrome) 
    • Scabies
    • Toxic Shock Syndrome
    • Stevens-Johnson syndrome and Toxic epidermal necrolysis
    • Staphylococcal scalded skin syndrome
    • Tinea corporis

Please rate topic.

Average 5.0 of 9 Ratings

Thank you for rating! Please vote below and help us build the most advanced adaptive learning platform in medicine

The complexity of this topic is appropriate for?
How important is this topic for board examinations?
How important is this topic for clinical practice?
Topic COMMENTS (32)
Private Note