What are the causes of a full-body maculopapular rash, including the hands, feet, and palms, accompanied by a sore throat?

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Differential Diagnosis for Full Body Maculopapular Rash with Sore Throat

Single Most Likely Diagnosis

  • Viral Exanthem (e.g., measles, rubella, roseola, or enteroviral infections): These are common causes of full-body maculopapular rashes, often accompanied by systemic symptoms like sore throat, fever, and malaise. The rash's distribution, including hands, feet, and palms, along with the sore throat, makes viral exanthem a leading consideration.

Other Likely Diagnoses

  • Scarlet Fever: Caused by Group A beta-hemolytic streptococci, it presents with a characteristic rash (which can appear maculopapular), sore throat, and fever. The rash can spread to the palms and soles.
  • Infectious Mononucleosis (Mono): Caused by Epstein-Barr virus (EBV), it can present with a rash, sore throat, fever, and lymphadenopathy. The rash can be maculopapular and is more common in patients who receive ampicillin.
  • Kawasaki Disease: An acute febrile illness of childhood characterized by a maculopapular rash, fever, conjunctivitis, erythema of the lips and oral cavity, changes in the extremities, and cervical lymphadenopathy. It's a consideration in pediatric patients.

Do Not Miss Diagnoses

  • Secondary Syphilis: Can cause a maculopapular rash on the palms and soles, along with systemic symptoms like sore throat. It's crucial to consider due to the potential for severe complications if left untreated.
  • Meningococcemia: A life-threatening infection caused by Neisseria meningitidis, which can present with a rash (often petechial or purpuric but can appear maculopapular initially), fever, and sore throat. Prompt recognition and treatment are critical.
  • Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis (SJS/TEN): Although more commonly associated with mucosal involvement and skin necrosis, early stages can present with a maculopapular rash and systemic symptoms. It's a medical emergency, often drug-induced.

Rare Diagnoses

  • Erythema Infectiosum (Fifth Disease): Caused by Parvovirus B19, it typically presents with a "slapped-cheek" appearance followed by a maculopapular rash on the body. It's less likely to cause sore throat but can be considered in the differential.
  • Pityriasis Rosea: A skin condition that starts with a herald patch, followed by a widespread, symmetrical, maculopapular rash. It's rarely associated with systemic symptoms like sore throat but could be considered if the rash's appearance and distribution fit.
  • Drug Reactions: Certain medications can cause a maculopapular rash as part of a drug reaction. While not a disease per se, it's an important consideration, especially if the patient has recently started new medications.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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