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Maculopapular Rashes - THE ALGORITHMIC APPROACH 

The term maculopapule is a portmanteau, a combination
of macule and
Maculopapular Rashes ... febrile have a wide differential ... have a broader differential ... meningococcemia, RMSF, and syphilis ... Central #Peripheral #Differential
Approach to the Rash in a an oncology patient - MINT-C Mnemonic
M - Malignancy: Leukemia cutis,
Approach to the Rash ... patient - MINT-C Mnemonic ... dermatoses #skin ... #Rash #oncology ... #differential #
Central Distribution, Febrile / Ill:
 - Viral Exanthem 
 - Lyme Disease (erythema migrans) 
Central Distribution,
/ Ill, Target Lesions ... meningococcaemia - Syphilis ... twitter.com/BirksMD #Maculopapular ... Macules #Papules #Rash ... #Dermatology #Skin
Infectious Joint Pain - Differential Diagnosis Algorithm 
Polyarticular Join Pain
 • Viral Myalgia
 • Viral Arthritis
Pain - Differential ... • Secondary Syphilis ... Papules & Mucosal Lesions ... & Symmetrical Rash ... (Measles- like rash
CNS Ring-Enhancing Lesions - Immunocompromised vs Immunocompetent
Multiple Ring-Enhancing Lesions:
 • Toxoplasmosis (CD4 < 100)
 • Other
, may also see skin ... splenomegaly Other infections ... Infectious: ... Tuberculosis • Syphilis ... #Brain #differential
Maculopapular - Diagnostic Algorithm
Pathophysiology:
- Catch-all term with a wide range of potential pathophysiologic mechanisms and causative
Maculopapular - ... or fluid-filled lesions ... sulfa-drug - Skin ... #Maculopapular ... Targetoid #Algorithm #Differential
Natural History of Syphilis
Primary - 2-6 weeks after infection
 • Chancre, Regional lymphadenopathy
Early Latent ≤ 1
-6 weeks after infection ... ≤ 1 year after infection ... • Rash, Fever ... lymphadenopathy, Mucosal lesions ... > 1 year after infection
SCORTCH Congenital Infections Mnemonic
S - Syphilis
C - CMV
O - Other
R - Rubella
T - Toxoplasmosis
C - Chickenpox
SCORTCH Congenital Infections ... Mnemonic S - Syphilis ... HCV #SCORTCH #Infections ... #Mnemonic #pediatrics ... #diagnosis #differential
Stages of Syphilis
Early Primary:
 • Painless chancre
 • Regional lymphadenopathy
Early Secondary:
 • Fever, malaise
 • Rash
Stages of Syphilis ... Fever, malaise • Rash ... first year of infection ... Gummatous • Nodular lesions ... in bone, skin,
Christmas Tree Rash of Pityriasis rosea
 - small oval scaling patches
 - Christmas tree pattern
 -
Christmas Tree Rash ... - long axis of lesion ... parallel to lines of skin ... palms/soles - Differential ... diagnosis: secondary syphilis