differential diagnosis:
1) dengue fever
- transmitted by aedes mosquito
- symptoms appear 3 to 14 days after infective bite
- dengue triad = fever, rash, headache
- character of the scar = whitish center surrounded by redness skin
2) kawasaki disease
- characterized by high fever
- together with at least 4 of the followings
: conjuctivitis
: redness / swelling of hands and feet
: rash
: cervical lymphadenopathy
: strawberry tongue
- always appear toxic, irritable, non-active
- never unilateral
3) measles
- spread by coughing & sneezing
- high fever begins at day 10 to day 12 & lasts for 7 days
- characterized by 3c (cough / coryza / conjuncivitis)- slowly fades away at day 7 to day 9
- scar was brownish coppery hyperpigmented macule aka post-inflammatory hyperpigmented macule
4) hand footh mouth (HFM)
- caused by enterovirus eg coxsackie
- spread by direct contact with the virus
- clinical features include mouth ulcer, rashes on the palm & sole
5) chicken pox
- caused by varicella-zooster virus
- an air-borne disease
- contagious five days before & five days after the rash appeared
- no longer contagious when the scar / crust present
6) rubella
- contagious one week before the rash appeared & one week after the rash disappeared
- possessed a lifetime immunity once being infected
- post cervical lymphadenopathy
7) SLE
- an autoimmune disease
- mainly affect women
- criterias to diagnosed SLE
: malar / butterfly rash
: patchy redness that cause scarring
: photosensitivity
: mucous membrane ulcers
: arthritis
: pleuritis / pericarditis
: kidney abnormalities
: seizure / psychosis
: blood count abnormalities
: immunologic disorder
: positive antinuclear antibody
8) scrub typhus
- caused by orientia tsutsugamushi
- infected by the bites of chigger
- characterized by aschar / necrotic lesion & abdominal pain
- usually in groin area
- treatment = doxycycline
- tested with immunoperoxidase test
- infected by group A streptococcus
- very high fever associated with lymphadenopathy
- characterised by strawberry tongue / sore throat
- macular rash of sandpaper appearance
- toxic looking
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