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all right. I have real. So, yeah, this is a shot of boys rashes. Intense was quite common. Presentation on any and a spoon. Also, my rules GP is well, be very common to see this can also be a cause of concern for parents on for clinical staff, if you know, and aware off the different diagnosis. So we're just going to go over that on go over some of the common ones there. So Yep. Overview of common rashes and a nanny setting basic management of Children with the rashes, potential, pet falls and difficulties and diagnosis. No, I'm just going to a few cases here on, um, see. See what you think. Hopefully what? You'll learn something here. So it's common presentation in any A san Often, parents are very concerned. I often would see that where child looks very well. Maybe his plan, um, around the rim. But the mom is really concerned about this rash. Um, so I think that me and reason for that is probably about the parent awareness. A bite? Um, meningitis. Um, I think parents really appreciate that better reassurance. And I think that's probably one of the big things. Actually, certainly from a medical point of view and you're seeing these patients if they are whale, is to give them reassurance that that rash isn't anything serious or worrying. And sometimes even for a parent having a legal on it can be very helpful thing on me to take my mask off here, so and kind of guy categorizing rashes expose. This could be helpful if you are triaging of the nurse. Some of the different terminology you can use can be helpful in terms of diagnosing. And so Markel is basically flat. It's skin level rash, popular nordle plaque these old MRI years, right? So if you just look along the level of the skin, um, it seems reused. A nodule would be significantly more reused. Um, then a popular that plaque, um, unpopular plaque ourself divided in terms of size, which you don't really need to know about it. But again, if you're looking at the rice, it's useful. Even if you can use terminology, Jared term know that we can use to solar reused area of skin. Lester's is another thing, obviously, swelling of skin containing fluid. Our theme is always just wrapping us, Um, and then particular purpose. A ecchymosis. These are the non black blanching rashes, which we would often see you in the triage if there is, if it has blanching or norm blanching, very useful to do not obviously in terms of thinking about the diagnosis. And again, those terms particular a purpura ecchymosis based really on size. If you're being quite small, liking most is being larger. But again, you don't need to worry so much. But if you can recognize again that that is a counter, very would think about the blood blanching and non blanching or I should be very significant, obviously. So just gonna do a few cases here. So this is a seven year old girl, a tandem with three day history of the whites. Bedrock temperatures were just appetite, usually very sudden. Well, but you can see there from your little group. Iraq's there always. Nothing very remarkable has a rash, which is blanching some large blisters, and this is what it looks like. Sorry, that picture quality hasn't great there. And this is a very classic of check and pox. So large red blisters, very caring for child. Um, so just a little better by checking clocks. Obviously, it's very common in the community. Usually primary school kids get it reinfections rare. Sometimes you'll say the parents. So this is the parents will say to you. This is the second time my child has chickenpox. If you're thinking about that, I understand. Either you maybe have the diagnosis Roll or the diagnosis was drawn in the past because it really is very rare. Unless judges I'm, you know, suppressed. The big thing with chicken pox is that has a long incubation period. So it's to your even three weeks before the rash comes like they will have that on. They will be in factious from it five days. Post rash, they say, until the blessed ear's kind of crossed over five days. Not something that parents would want to know. If you're seeing a challenge with checking part in your heart rhythm to go home, um, obviously from our point of view and any if there are any pregnant women and members of staff, you would want to avoid contact of possible with, um, and although again, most women will have um, Unit eight the symptoms. A rush temperature, just appetite treatment includes on the Testim you know, was it match? A million can help began without the parsimony tent. Avoid a nonsteroidal anti inflammatory like Griffin, and the reason for that is there is an association with necrotizing fasciitis. Um, it's no, it's not a very well evidenced association, but it's something that we would tend to avoid just because obviously, necrotizing fasciitis is a very significant thing. So complications, pneumonia, say late US so you can get in the fact that obviously blessed during areas and seizures, that's quite rare all this day, but very significant. Um, so and again, um, sometimes Mom's pregnant woman will be concerned if the other contact with chickenpox if they're non immune not can be significant, especially in the third train master. So sometimes Mom's might come. Some and GP get often. There is a blood test that can be done the GP to see if they are immune on um and um, if they have hard contact with checking parks, obviously as well, I would advise any parent of a child that's going home just to avoid any contact with anybody who's immune suppressed. He's going through chemotherapy or his own biologic treatment, things like that just to avoid any contact because it can be more severe in those cases. That's a better way of checking pox and next kiss. Two year old Chinese presents with drilling were just oral and tech. Nabi's about drier than usual, already had 130 a temperature. 30 staff on respected 30 Capri feel less into his overall for those younger where those observations for child, too, isn't too bad. So there's a rash, a blistery kind of rash noted on the hands are the mice, and this is what it looks like. So this is a handful. Nice, very common you in a slightly younger age group and chicken pox, usually kind of nursery age preschool about the county and older kids state and can even be an adults. Occasionally, I have seen a couple of times caused by Coxsackie Cook sake. Virus usually kept her well. With this on. They can have these small spots, so they're different from chickenpox. They're smaller on on, often around the mice around the hands and feet, but they don't need that for the diagnosis. Sometimes I've seen it just during the night, the area occasional spotting or in the hand or the mice? Yes, full to look inside the mice because off, then there will be a significant spots on the inside of my thumb. That's what will cause the child lot of distress. So the reason these kids end up getting a medal, if they do it is because they're just not drinking enough eso if we're seeing those kids for the now be there but drier than normal, useful to get analgesia and early on again, the death found spray, which we have easy access to those wells. I slowly even makes pops really good to see if you can just, you know, help that child get better without inpatient treatment. Um, sometimes it can be very significant with sports, and they do do Do you get quite the hydrea that on the do a part of the mission? But most of all, most of the time they don't. There's no specific isolation rules for this to some, parents will ask. You don't have to keep my kids off nursery. There's no guidance on up that you would. But some some nurses will say No, we're not taking the child back and tell their well again. So that's just about by town. Fit mice. Another kiss them four year old girl attended with high temperature norm blanching rash on dries. A numerical has treatment and no childhood immunizations given. Um, child has a zone immigrant when I wasn't having any vaccinations, so you can see they're capri fellas. Four heart rate, 107 day. Um, 10. 38. Point it respect. Great for you. So all those are significantly abnormal on do you obviously would be very concerned with this child from the point of triage. What, those kind of numbers? That's a a nonblanching rash. Um, okay, on the big concern here, which was started, this is meningea cocoa except the CVS. Without knowing blanching rash. All parents are very concerned about that. It's obviously a very rare thing. Important point to be aware that actually west meningococcus septicemia, you can have a blood check your eye. So obviously a blind a blinding rises know always going to be 100% field. See if the child is going to be well Mrs were again. You look at the child and obviously you've been teaching on that already. Looking at the child on a B, C. D approach A child like that drives his eye temperature significant there. That has not how the immunizations. Because obviously the immunization program has really richest. And the prevalence off manage, I'd us, um, so from our point of view, the ABCDE you're going to get a B calf tracks on. You're gonna get dexamethasone. Um, not, sir. Just a chance of hearing loss on you're going to get three Advils as us first. Really? Septicemia. Sepsis treatment on again. You're obviously going to get a consultant involved very early here. Pediatrics involved. I see you involved, um, just for very careful monitoring of these patients because they could be very sexy. So it's very rare thing. Teo, that rash on again, you have to look out for the more subtle signs. But obviously it's something something that is useful to be aware off. So this is just a little bit of it nonblanching rashes. And I didn't want to cover this all in cases. Um, it can be calling enough to get known. Lunching rashes say it's very unusual to get it from a result of men meningococcal septicemia. But these other causes air actually were comin on HSP stance arena Pinochle Lane Purpura. Um, usually child is quite well with us, but they've hardened. Usually GI symptoms the diarrhea, vomiting or sometimes upper respiratory tract infection. Like a call for runny noses preceding the rash kind of Tom A. P N's joint pains with a known blanching rash without kind of head straight, Um, you're going to be some kind of routine okay, online purpura. And that's important because on pediatrics need to follow those patients up, check their blood pressures, check kidney function. They have a protocol they follow. So obviously your affair patients to Pedes for that again. Something that we see no and frequently would be the third point. Don't know mechanical causes. So coughing vomiting very often will cause bunching and usually arrange that the eyes and around the fiercest area and on top of booze began. It's hard clinically, it's worthwhile. Ask and a senior to see whether bloods or needed often are concerned might be that they could have that condition. A bulb there that's on the side opinion, which can be caused by a viral illness, which would mean the platelets are very low, so that can obviously cause on these particular is nonblanching rash, but it's often about more weight spread. It's usually in the eyes. It's more likely to be a mechanical cause where there's been a little blood vessels that first just because of the pressure of coughing and vomiting. The only thing I always say they consider is no accidental injury. So you just have to keep bear that in mind, and it's worthwhile. Noting that if you're not concerned as well as if you're concerned about, um, kids for four year old child usually well presented, some known said ECI rash over the trunk. New Airway compromised all the Ultravate in their normal rash, which is reused rad, widespread. This is what the child looks like about on hard way. You can see the rash looks about red reused, but he and so Eric Aerial Rush multiple calls is very often it's a viral rash, and this it probably was common rash that kids would get is a viral rash, whether it's urticarial like re is or whether it's flat. Just a popular kind of red rash gonna be the most common presentation, probably that we would see any any and community context, so they usually have a call for only new sore through those kind of things and milk felt sometimes a white spread rash, just intermittent. Um, I suppose it again bear in mind that we're want to relate anaphylaxis. So you're looking again at your A B C D. Make sure officer's no airway compromise looking for swelling around the lips or eyelids is, yes, angioedema loser things. Just to be aware over in terms of the urticarial rash obviously can respond quite well. Time. The chest amines could be useful. And Colston reassurance. If it is just a nerve, carry a little rash on There's no obvious source, but you obviously would be asking about those triggers food medication. It's, uh, these are just a few pictures, Really. I'm not going to go in the mouth of details. So, um, first guns about you might think this is ringworm. It's got a bit of a cross that's well circumscribed. Just to be aware oversedate the other possibility. It says it could be a second at Burns. So, um, and I again just just consider this when you're looking at a rash like this and just think about the possibilities slapped cheek syndrome again something that can be common enough in the community but often comes after viral upper respiratory tract infection where you get a very red cheek or to to read shakes after a better the call for runny nose, sore head, um, those kind of things I would say parents are very aware of. That's, um, it's often that the title is just paper, except they'll be halt on now that they'll have a better read cheek or two red cheeks from a temperature that's not slapped cheek syndrome. You know, if they're if they just got a red cheek that goes down after a temperature. Usually kids are very well with this again. The big thing to think about again is pregnant Woman worried about contact because again, it can have an effect, Um, in terms of baby the first trimester, and particularly think so. And if there is, the thing is, once the rash comes like the child is no longer infectious. So from our point of view, yes, with the contact with the child, stop ticks and, um, in the house, a slapped cheek. You're not really worried. It's more again if there's been contact at home and there can be blood stumped to check most again. What? People are immune to this virus that causes it. But after not began, that could be blood stunned. It could speak. Teo maternity. About that again. Just a few more slates here. Um, scarlet fever. We've had a few outbreaks over the years since he calls. My strap could be usually associate with sore throat and temperature and just my algebra, maybe swollen lymph nodes on. Do you get this widespread kind of some paper type rash or very rough rash? And you can get also a strawberry tongue. So basically that the tongue one week I peel and then the skin can peel off on. Then they talk about the stroke. Great. Uncle, um, on again, um, sometimes you can get the skin, then becomes dry and cracked. It's just with considering is well with these patients. They have a what looks like a strawberry tongue and possibly have a hand involvement. You have to think of the condition called kawasaki disease. Um, usually have temperature for over five days without they can have conjunctivitis on. They have a number of all their symptoms, but there is a bit of overlap in terms of some of those, sometimes in terms of strap, um, infection calm calls. It's a peeling of the hounds. Changes to the tone temperatures on is probably more common than Kawasaki. But Kawasaki's important just to consider just over because it has a risk in terms of problems with the heart. And they would need folded up, going again, referred to pediatrics for that. You're concerned with that condition? Um, again, just a few couple more slights exam again, very common in kids. Occasionally we get kids with quite body aches, and I come to us. Something may be. In fact, did they get fact that oxygen because their skin is no intact, Maybe down the Botox there is a condition called Axid my her paddock. Um, what you do you see from time to time and kids cause but herpes virus. It can be about more on well, sometimes. And we need acyclovir. You can see it's kind of cross thing of the whites bread rice that this child has. Um, again, if you're concerned about that, it become be the repair that the pizza but could consider the usual treated with a monthly IV I really excited here, Um, and again, just a few more minor ones, Which empathy I go, which is gonna bacterial staph infection, which again is common in younger kids, Um and and yes, website described It was like a corn flex stuck on the fierce, which I think is quite a good description s so it can be very infectious. Can often be treated just with topical antibiotics. Sometimes where along the biotics or needed could spread around the fears off them and rain the mikes and the lips there on then, on another one I've seen a few times in any which is again molluscum contagiosum with very mild condition, but apparently worry if they become see a GP. Whatever. It's just these lesions often flesh, um colored with a better with them both in the middle. Then they're perfectly benign again. They just require ears reassurance. It's useful it again if you just know what they looked like just in case you do come across them. But again, um, that's a very quick overview of rashes and kids. And there are others office that I haven't mentioned there. That's just another view again. Just assess a child overall. Um, if you have any concerns, just obviously speak to senior right away. Um, And again, there's a few good resources energy as well, So it's actually very good, but the tea that I would use on his used often in GPS tells derm app to the New Zealand website on the patient UK is it has to be called patient. And so there's a rapist. Well, if your stock Arnold Cheras Well, okay, that's May. Don't think you Yeah.