Exanthems: A-to-Z Guide from Diagnosis to Treatment to Prevention

Introduction to exanthems:

At some point in many of the classic childhood illnesses, the children break out in a rash. The timing and nature of the rash can give important clues to diagnosis and treatment.

What are exanthems?

When an infection causes the ill child to break out with a rash that covers most of the body, the rash is called an exanthem, or an eruption.

Physicians first learned about exanthems in much the same way that toddlers learn about dogs. At first, all animals may be called “dogs.” As toddlers gain experience, only canines get that name.

In antiquity, these illnesses were all lumped together. Eventually, a distinction was made between measles and pox (with growing clarity over about a millennium). However, what people called the “pox” and what was then called the “measles” are now known to each include a variety of distinct diseases.

Six separate childhood exanthems were defined from what was once called the “measles.” In the early part of the 20th century, these were often referred to by number. Measles and scarlet fever were the first two to be separated. Rubella (German measles) was called “third disease”; atypical scarlet fever was “fourth disease”; erythema infectiosum was (and is) “fifth disease,” and roseola was “sixth disease.”

Chickenpox and smallpox, the other two classic childhood exanthems, were recognized as separate from each other in the 18th century. These both had blisters, or pox, that set them apart from the red rashes of the other group. Today, dozens of exanthems are recognized, including:

• Adenovirus
• Anthrax
• Mononucleosis
• Colorado tick fever
• Mumps, cat-scratch fever
• Rat-bite fever
• Rocky Mountain spotted fever
• Relapsing fever
• Meningococcemia
• Typhus
• Hand-foot-mouth disease
• And many others

Related concepts:

Rash illnesses, Childhood rash.