Last reviewed: 27 Sep 2021
Last updated: 09 Jun 2021

Summary

Differentials

Common

  • Allergy to food or drug
  • Insect bites or stings
  • Adverse drug reaction (e.g., to antibiotic, anticonvulsant, or allopurinol)
  • Chemotherapy
  • Enterovirus and echovirus infection
  • Fifth disease (erythema infectiosum)
  • Roseola infantum (sixth disease)
  • Epstein Barr virus (EBV) infection (infectious mononucleosis)
  • Cytomegalovirus (CMV) infection

Uncommon

  • Iodinated contrast media nonimmediate adverse reaction
  • Toxic epidermal necrolysis/Stevens-Johnson syndrome
  • Drug reaction with eosinophilia and systemic symptoms
  • Erythema multiforme
  • Systemic hypersensitivity syndrome
  • HIV-seroconversion exanthema (also known as acute retroviral syndrome)
  • Acute hepatitis B virus infection
  • Acute hepatitis C virus infection
  • Rubella (German measles)
  • Rubeola (measles)
  • Meningococcemia
  • Scarlet fever
  • Staphylococcal scalded skin syndrome
  • Toxic shock syndrome (Staphylococcus exotoxin)
  • Rocky Mountain spotted fever or Mediterranean spotted fever
  • Acute graft-versus-host disease
  • Kawasaki disease (mucocutaneous lymph node syndrome)
  • Juvenile-onset or adult-onset Still disease
  • Syphilis (secondary)
  • Ebola virus infection
  • Zika virus infection
  • Chikungunya virus infection
  • Dengue fever

Contributors

Authors

Adelaide A. Hebert, MD

Professor & Director of Pediatric Dermatology

Department of Dermatology and Pediatrics

UTHealth McGovern Medical School Houston

Houston

TX

Disclosures

AAH has received research grants paid to UTHealth McGovern Medical School Houston from Pfizer, Anacor, GlaxoSmithKline (GSK), Mayne, Novan, Arcutis, Verrica, and Cutanea; has received honoraria from Pfizer, Verrica, Cutanea, Novan, and Mayne; and is on data safety monitoring boards for GSK, Ortho Dermatologics, and Regeneron-Sanofi.

Yamila Goenaga Vazquez, MD

Clinical Research Fellow

Department of Dermatology

University of Texas Health Sciences Center in Houston

Houston

TX

Disclosures

YGV declares that she has no competing interests.

Acknowledgements

Dr Adelaide A. Hebert and Dr Yamila Goenaga Vazquez would like to gratefully acknowledge Dr Quoc-Bao Nguyen, Dr Mary DarConte, Dr Mark Naftanel, and Dr Hobart W. Walling, previous contributors to this topic.

Disclosures

QN, MD, MN, and HWW declare that they have no competing interests.

Peer reviewers

Brian Swick, MD

Clinical Assistant Professor

University of Iowa College of Medicine

Iowa City

IA

Disclosures

BS declares that he has no competing interests.

Kimberly Schulz, MD

Dermatologist

Town Square Dermatology

Coralville

IA

Disclosures

KS declares that she has no competing interests.

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