Bugs Causing Rashes 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 followed 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 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 lata Alopecia (patchy) Constitutional symptoms Lymphadenopathy 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