Dermatology - Viral Exanthem

Dermatology - Viral Exanthem 
Primary systemic viral infections commonly manifest with distinctive mucocutaneous rashes, exanthems, and enanthems. An exanthem refers to a rash that appears on the skin as a result of a systemic condition. Enanthem, on the other hand, refers to mucosal lesions that are commonly connected with a systemic disorder that also causes an exanthem. These conditions are primarily caused by viral agents, although they can also result from bacterial, parasitic infections, or be triggered by drugs/toxins or autoimmune responses.

Certain viral exanthems have distinct morphologies, but, clinical symptoms alone may not always lead to an appropriate diagnosis. Obtaining a patient's medical history might provide valuable information, such as the time of year, any recent exposure to diseases, immunization records, past instances of skin rashes, and any symptoms experienced before the rash appeared. Measles is accompanied by conjunctivitis.
Prodrome refers to the early symptoms or warning signs that occur before the onset of a disease or medical condition.
The individual is experiencing an acute infection characterized by symptoms such as fever, fatigue, nasal congestion, sore throat, feelings of sickness, vomiting, diarrhea, stomach discomfort, and headache. The presence of lymphadenopathy, hepatomegaly, and splenomegaly is possible.

Morbilliform refers to a widespread rash that starts as individual spots and subsequently merges together. The rash typically appears in the central areas of the body, such as the head, neck, trunk, and proximal extremities, and spreads outward from there. Lesions have the potential to develop hemorrhage and exhibit petechiae. The scarlatiniform eruption manifests as a widespread and uniform redness of the skin. The vesicular eruptions first appear as small blisters with transparent fluid, which may develop into pustules. These pustules eventually detach and lead to erosions. Oropharyngeal lesions encompass several manifestations such as Koplik spots in cases of measles, petechiae on the soft palate (known as Forchheimer sign) in cytomegalovirus (CMV) or Epstein-Barr virus (EBV) infections, and microulcerative lesions in herpangina caused by coxsackie virus A.

The diagnosis is mostly based on clinical evaluation and can be further validated with serological or cultural analysis, depending on the specific requirements. Differential diagnosis encompasses cutaneous drug eruption, systemic lupus erythematosus, and Kawasaki syndrome, all of which have negative effects on the skin.

Supportive care is usually sufficient for most viral infections, however antiviral drugs might be beneficial in the early stages of the illness. Vaccination is a highly effective method for preventing most viral infections.