Where in the World Did You Get That Rash?

Panteha Eshtiaghi; Miriam Weinstein

doi:10.1542/pir.2018-0200

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Panteha Eshtiaghi, HBSc*
Miriam Weinstein, MD, FRCPC^†

^*Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
^†Hospital for Sick Children, Toronto, Ontario, Canada

AUTHOR DISCLOSURE
Ms Eshtiaghi has disclosed no financial relationships relevant to this article. Dr Weinstein has disclosed that she has led advisory board meetings for Pfizer related to a new eczema product; has served as a consultant on skin care for Paladin Labs; has served as a consultant for a continuing medical education program for pharmacists on eczema management for Rx Briefcase; has served as an advisory board member for Johnson & Johnson on eczema and sun protection products; has served on an advisory board for Sanofi-Genzyme; and has received funds to develop an eczema teaching program for patients and families through a grant provided to the Hospital for Sick Children Foundation by La Roche-Posay. This commentary does contain a discussion of an unapproved/investigative use of a commercial product/device.

Abbreviations:

ACD:: allergic contact dermatitis
CD:: cercarial dermatitis
CL:: cutaneous leishmaniasis
CLM:: cutaneous larva migrans
DF:: dengue fever
HFMD:: hand, foot, and mouth disease
HSV:: herpes simplex virus
KD:: Kawasaki disease
PCR:: polymerase chain reaction
PR:: pityriasis rosea
RT-PCR:: reverse transcriptase polymerase chain reaction

Practice Gaps

The challenge to diagnose cutaneous eruptions and lesions in patients who have spent time in foreign countries is increasingly common. With the advent of increased global travel, foreign adoptions, immigration, and refugee seekers, rashes that were once relegated to the realm of the exotic and likely to show up in a tropical diseases clinic may now present to a general pediatrician. Furthermore, the pediatric traveler is at increased risk for dermatoses. (1) It behooves the practitioner to be aware of these skin findings, to be able to recognize them and distinguish them from other skin conditions.

Objectives

After completing this article, readers should be able to:

Identify and classify rashes by main morphologic patterns.
Develop a broad differential diagnosis and diagnostic approach for a rash in a returned pediatric traveler based on initial morphology, history, epidemiology, and other clinical features.
Consider both infectious and noninfectious causes of skin disorders presenting in a patient with a travel history.
Outline the basic investigations and principles of management for travel-acquired and non–travel-acquired dermatologic illnesses.
Discuss …