Main menu
Common skin conditions
NEWS
Join DermNet PRO
Read more
Quick links
For each of the ten cases, study the image(s) and then answer the questions. You can click on the image to view a larger version if required.
Each case should take approximately five minutes to complete. There is a list of suggested further reading material at the end of the quiz.
When you finish the quiz, you can download a certificate.
List febrile illnesses that may result in a rash.
Fever and rash most commonly indicates a bacterial or viral exanthem, but the differential diagnosis includes drug eruptions and Sweet's disease. Exanthems more commonly affect children than adults. Your list could include: chickenpox (varicella), measles (morbilli), German measles (rubella), roseola, fifth disease (erythema infectiosum), infectious mononucleosis, streptococcal scarlet fever, staphylococcal scalded skin syndrome, meningococcal disease, Kawasaki's disease and rickettsial infections.
From the clinical appearance, what is the most likely diagnosis?
Chickenpox (varicella), characterised by numerous erythematous papules and a few vesicopustules on the patient's trunk. Many lesions are crusted.
What complications may arise in adults?
Chickenpox is considered a minor infection of childhood, but in adults it is more likely to result in disseminated disease. This is especially dangerous in immune suppressed patients. Complications include gastroenteritis, pneumonia, encephalitis and thrombocytopaenic purpura. Chickenpox predisposes to severe Group A streptococcal skin infection including necrotising fasciitis.
Outline appropriate management.
The patient should be carefully examined and investigated to determine the extent of her infection. High dose oral aciclovir (800mg five times daily for 7 days) should be considered if the diagnosis is made within 3 days of onset.
If she was pregnant, would her fetus be affected?
Maternal chickenpox in the first 20 weeks may result in congenital varicella, (limb hypoplasia, cortical atrophy, cataracts). If varicella arises at the time of delivery, the neonate may develop severe disseminated disease. Herpes zoster arising without a prior history of chickenpox may be due to infection in utero.