From the Guidelines
A maculopapular rash is a skin condition characterized by a combination of flat, discolored areas (macules) and raised bumps (papules) that may appear red, pink, or purple, and its diagnosis and management should prioritize identifying and addressing the root cause to minimize morbidity, mortality, and improve quality of life. This type of rash typically spreads symmetrically across the body, often starting on the trunk and spreading outward to the limbs. Common causes include viral infections like measles and rubella, drug reactions, bacterial infections, and autoimmune conditions 1. The rash may be accompanied by other symptoms such as fever, itching, or general discomfort depending on the underlying cause.
Causes and Symptoms
- Viral infections: measles, rubella, roseola, enteroviral infection, Epstein-Barr virus infection 1
- Bacterial infections: Rocky Mountain spotted fever, meningococcal infection, Mycoplasma pneumoniae infection, leptospirosis, secondary syphilis 1
- Drug reactions: discontinuing the medication may be necessary 1
- Autoimmune conditions: Kawasaki disease, thrombotic thrombocytopenic purpura (TTP), immune complex-mediated illness 1
Diagnosis and Management
- Medical evaluation is important for proper diagnosis and treatment, especially with fever or other concerning symptoms 1
- Treatment depends on identifying and addressing the root cause - for viral infections, supportive care is usually sufficient; for drug reactions, discontinuing the medication may be necessary; and for bacterial infections, antibiotics might be prescribed 1
- Hospitalization and empiric antibacterial therapy with vancomycin plus antipseudomonal antibiotics may be recommended for severe cases 1
Prognosis and Quality of Life
- Early diagnosis and treatment can improve outcomes and reduce morbidity and mortality 1
- Delayed diagnosis and treatment can lead to increased mortality and poor quality of life 1
- It is essential to prioritize medical evaluation and treatment to minimize the risk of complications and improve quality of life.
From the Research
Definition of Maculopapular Rash
A maculopapular rash is a type of skin rash characterized by a flat, red area on the skin that is covered with small, raised bumps or patches [ 2 ].
Causes of Maculopapular Rash
The causes of maculopapular rash can be varied and include:
- Infectious processes such as meningococcemia, infectious mononucleosis, West Nile virus, zika virus, rubella, primary human immunodeficiency virus, parvovirus B19, and ebolavirus [ 2 ]
- Tick-borne illnesses like Rocky Mountain spotted fever and ehrlichiosis [ 2 ]
- Hypersensitivity reactions, including exanthematous drug reactions [ 2 ]
- Multiple drug hypersensitivity, a novel syndrome mainly seen with severe delayed type IV drug eruptions, involving long-lasting strong T-cell reactivity to two or more structurally unrelated drugs [ 3 ]
Characteristics of Maculopapular Rash
Maculopapular rash can present with fever and can be severe, as seen in a case of a 54-year-old female with hairy cell leukemia who developed an extensive severe maculopapular exanthema with perifollicular hemorrhage [ 3 ].
Diagnosis of Maculopapular Rash
Diagnosis of maculopapular rash can be aided by an algorithm that considers various conditions that result in a fever and maculopapular rash in adults [ 2 ]. Drug patch testing and delayed intradermal testing can also be used to diagnose multiple drug hypersensitivity [ 3 ].