Infectious Exanthems

Many viral infections are associated with generalized morbilliform cutaneous eruptions. The list is exhaustive, but the most common include adenoviruses; cytomegalovirus; coxsackie and echoviruses; Epstein-Barr virus; hepatitis B virus; human herpesvirus-6; paramyxovirus; respiratory syncytial virus; rotaviruses; rubella virus, and human immunodeficiency virus. Other agents associated with generalized eruptions include mycoplasma; Borrelia spp; Legionella; Leptospira; Listeria; meningococci; rickettsiae; and Treponema pallidum. Erythematous macules and papules, or, less often, vesicles and petechiae, usually develop centrally, sparing the palms and soles. Diagnosis and differential diagnosis are based upon history and physical examination. Drug eruption should always be considered in the differential. Skin lesions usually resolve in 7 to 10 days, and are treated symptomatically.

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