Ask Emily

23 02 2012

Why does our skin break out in a rash with some viral infections like measles or Fifth disease?

These sorts of rashes are technically known as viral exanthems (the word derives from the Greek word “exanthema,” meaning “breaking out”).

The skin responds to infection with a rash for one of three reasons: the infectious agent releases a toxin that causes the rash, the infectious agent damages the skin and causes a rash, or the immune response results in the skin outbreak.

The skin responds in only a few ways to these challenges, although the pattern of the response can vary from virus to virus (bacteria and some other infectious organisms can also trigger a rash).

The response is the body’s attempt to deal with the presence of viral particles that find their way to the epidermis, or skin. In general, the upshot of the immune response is an area of inflammation. Because viruses cause a systemic or body-wide infection, viral rashes often cover much of the body.

Although the basic pathway to the rash is similar among viruses, the specific pattern of the rash can help distinguish the virus involved. For example, Fifth disease, so-named because it was the fifth virus in a series to be identified as causing a rash, produces a “slapped-cheek” ruddy appearance on the face and may cause a lacy, rather flat rash elsewhere on the body.

A measles rash, on the other hand, starts as an eruption of raised or flat spots behind the ears and around the hairline before spreading body-wide.

One thing to recognize is that not every rash is a viral rash or a benign viral rash, although most viral rashes will resolve on their own. Usually, a fever accompanies a viral rash. If a rash develops, you should be aware of the following warning signs that signal a call to your doctor:

  • If you suspect you have shingles. This highly uncomfortable rash tends to trace along the nerve routes under the skin but can spread out from those, as well. Starting antivirals within the first 24 hours may ward off a more intense recurrence or a permanent pain syndrome called postherpetic neuralgia.
  • If you suspect measles. Infection with this highly contagious virus should be reported immediately.
  • What you think is a rash from a severe allergic reaction or a rash that arises coincident with taking a new medication.
  • The rash accompanies a high fever, spreads rapidly, and starts to look like purple bruising. This pattern is indicative of meningitis.
  • Any rash involving a very high fever, pain, dizziness or fainting, difficulty breathing, or a very young child or that is painful.
  • Any rash that you find worrisome, including for reasons of persistence or timing with something such as exposure to infection, a new medication, or new food.

Do you have a question for Emily? Send it to: pkids@pkids.org

By Emily Willingham

Image courtesy of HowStuffWorks





Fifth Disease? What About Third or Fourth?

21 07 2011

Last summer, PKIDs’ advice nurse, Dr. Mary Beth, explained what fifth disease is: a viral rash that is tricky to contain because by the time you get the rash, you’re already through the contagious stage.

The rash itself is not painful and most children get through it without any problems, although adults may experience joint pain with this infection.

If a pregnant woman catches it, there is a small risk that the unborn baby will have severe anemia and the woman may have a miscarriage.

It’s also worse for people with sickle cell disease. Their red blood cells can get dangerously depleted during a bout with fifth disease.

Why is this condition known by a number instead of a real name? The vernacular term “slapped cheek syndrome” isn’t too endearing; neither is its scientific moniker, “erythema infectiosum,”  nor “parvovirus B19,” the name of the organism that causes it.

Even “variola” has a certain melodic ring to it, and that (smallpox) was the Chuck Norris of infectious disease.

It turns out that, by old tradition, several of the rashy illnesses of childhood were known by numbers:

  • First disease was measles
  • Second disease was scarlet fever, caused by the same bacterium that causes strep throat
  • Third disease was rubella
  • Fourth was Duke’s disease, which is not a defined disease today
  • Fifth, our friend erythema infectiosum
  • Sixth, roseola—which sounds a lot like rubella and rubeola—is actually caused by a couple of strains of herpes viruses

It seems that, just like squirrels are said to be rats with good PR, the names of the other diseases were relatively euphonious compared to “erythema infectiosum,” and so the rather anonymous “fifth disease” was the name that stuck.

Frankly, the whole rubella-rubeola-roseola conglomerate might be easier to keep straight if each of those diseases were still referred to by number. Maybe it’s time fifth disease got the charming name it’s never had. How about . . . slappacheeka? Rosella? Gwendolyn?

By Ms. Health Department

Image courtesy of http://healthpictures.in/





Monkeypox

2 07 2010

This blog is a long time coming. We heard about monkeypox a few years ago and wanted to write it up just so we could use the word “monkeypox.”

Turns out, monkeypox the disease isn’t as funny as the word. When infected, one gets a blistery rash similar to smallpox. In areas of Africa where the virus is endemic, one to 10 percent of human cases end in death.

Although the virus was first detected in monkeys, other animals can become infected, including humans

The first outbreak of monkeypox detected in the U.S. was in 1993 and probably started with animals imported from Africa infecting pet prairie dogs, who then infected humans.

Monkeypox can be transmitted in unusual ways, including through the consumption of bushmeat—legal (or illegal) wild animal meat imported to cities in Europe and the U.S.

There’s no specific treatment for monkeypox and prevention methods are the usual: handwashing, avoid sick animals, and practice standard, contact, and airborne precautions.

Turns out monkeypox just isn’t funny.