Bugs Causing Rashes Bug 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 Diffuse Condylomata lataAlopecia (patchy)Constitutional symptomsLymphadenopathy 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