L is noted to have a widespread morbilliform rash
covering 50% to 60% of her body.
In the study, published in the Journal of the American Academy of Dermatology, Shoko Mori of the dermatology service at Memorial Sloan Kettering Cancer Center, New York, and coauthors looked at 49 cancer patients hospitalized (41) or treated at an urgent care center (8), between August 2016 and July 2017 who experienced a morbilliform rash
. Overall, 27 patients had a simple morbilliform rash
, without systemic involvement; 22 had a complex morbilliform rash
with systemic involvement, including 9 with cutaneous manifestations of graft versus host disease (GVHD) and 13 with rashes secondary to drug exposure.
The youngest patient was a 4-year-old girl, who developed a morbilliform rash
following cotrimoxazole intake for respiratory infection.
The most common cutaneous morphology at the presentation was morbilliform rash
, including maculopapular rash
and exanthematous rash
(95.0% in SJS; 68.8% in overlap-TEN); there were significant differences between the SJS and overlap-TEN groups for morbilliform rash
(P = 0.036).
Out of total 25 patients with cutaneous drug reactions, morbilliform rash
was the most common (Figure 3).
A relative of dengue, the chikungunya virus can present in the form of a morbilliform rash
, nasal hyperpigmentation, purpuric macules, and erythema, the latter of which can sometimes be accompanied by ulcers.
Skin exam showed a pruritic morbilliform rash
on the neck, upper extremities, trunk, buttocks, and lower extremities with dermatographism.
It can be distinguished from SJS where the total surface of body surface area detachment is less than 10% by definition.7 A morbilliform rash
is the most common reaction to phenytoin occurring in as many as 5% of cases overall.
Classification of beta-lactam reactions by the time between administration of the drug and the reaction and by its relation with IgE (7,8) Early (<1 hour) and rapid reaction (1-72 hours) (IgE-mediated): Urticaria Laryngeal edema Bronchospasm Hypotension Regional swelling Delayed (after 72 hours): Morbilliform rash
Urticaria Severe delayed reactions (non-IgE-mediated): SJS TEN DRESS Interstitial nephritis Pulmonary involvement Vasculitis Hemolytic anemia SJS: Steven-Jonhson syndrome; TEN: toxic epidermal necrolysis; DRESS: drug rash
eosinophilia and systemic sypmtoms Table 3.
When investigated by public health officials on April 6, the patient had a morbilliform rash
, cough, coryza, conjunctivitis, and Koplik spots, and reported no recent travel or contact with ill persons.
(6) For this study, the following were designated the 'classic dermatological measles syndrome': Koplik's spots, other typical oral manifestations (stomatitis), conjunctivitis, and a morbilliform rash
with cephalocaudal spread.
The patient had no history of enanthem (Koplik spots) or morbilliform rash
before or after symptom onset and no documented history of measles vaccination.