Version May 2024
| Viral exanthems | |
| Measles (rubeola) | The "brick-red" maculopapular rash often begins on the head and neck area and spreads centrifugally. Patients also complain of fever, cough, coryza, and conjunctivitis. Koplik spots (tiny, punctate, elevated, white buccal mucosa lesions located adjacent to the lower molars) are pathognomonic of measles and can precede the rash by 24 to 48 hours. |
| Rubella | The rash resembles measles, but the patient does not appear to be sick. Prominent postauricular, posterior cervical, and/or suboccipital adenopathy also assists in the diagnosis. |
| Erythema infectiosum or "fifth disease" (human parvovirus B19) | Children, unlike adults, often develop a characteristic rash with a "slapped cheeks" appearance. |
| Roseola infantum or exanthem subitum (human herpesvirus 6 or 7) | Primarily seen in infants and young children, it is characterized by high fever for 3 to 4 days, followed by generalized, maculopapular rash that spreads from the trunk to the extremities but spares the face. |
| Infectious mononucleosis (Epstein-Barr virus or cytomegalovirus) | Maculopapular rash, usually occurring after administration of ampicillin, in older children, adolescents, or young adults with pharyngitis, fever, lymphadenopathy. |
| HIV infection | A transient, maculopapular, nonpruritic rash, located on the trunk or face, may occur in the acute retroviral syndrome, 2 to 4 weeks after the primary HIV infection. Fever, sore throat, malaise, headache, lymphadenopathy, and mucocutaneous ulceration are accompanying symptoms. |
| Bacterial exanthems | |
| Scarlet fever | Coarse, sandpaper-like, erythematous, blanching rash, occurring most commonly in the setting of pharyngitis from group A streptococcus infection. |
| Mycoplasma pneumoniae infection | Mild, erythematous, maculopapular or vesicular rash, most commonly accompanying respiratory tract infections. Rarely, erythema multiforme or RIME. |
| Maculopapular rash associated with autoimmune connective tissue disease | |
| Juvenile idiopathic arthritis and adult-onset Still disease | Evanescent, salmon pink, maculopapular rash occurring with fever. The rash predominantly involves the trunk and extremities but can also involve the palms, soles, and, occasionally, the face. |
| Acute cutaneous lupus erythematosus | Widespread, morbilliform eruption often focused over the extensor aspects of the arms and hands. Typically precipitated or exacerbated by exposure to ultraviolet light. |
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