A 5-year-old girl has had a rash on her arms and trunk for the past 48 hours and complains of pruritus. Three types of lesions are noted are macules, papules, and vesicles. Some of the vesicles have crusts
Based on your examination, you hypothesize the girl has which disorder? a. varicella c. psoriasis
b. scabies d. impetigo
A
Varicella, or chickenpox, is characterized by red macular and papular lesions that are intensely pruritic. The lesions start on the trunk and proceed to the extremities. Papules progress to thin-walled vesicles, pustules, and crusts. It is caused by the varicella zoster virus. The patient may exhibit all of the lesions simultaneously. Scabies is seen as red, pruritic papules or vesicles with S-shaped or straight-line burrows. It is caused by mites and may be visible as a small, dark area within the vesicle. Psoriasis has pruritic silvery scales of the epidermis that have clearly demarcated borders and underlying erythema. The lesions are circular and are found mainly on the elbows, knees, and behind the ears. The lesions of impetigo are vesicles or bullae that measure 1 to 2 cm and become pustular and rupture easily, discharging straw-colored fluid. The drainage becomes thick as it dries and produces golden-honey colored crusts. It is caused by group A streptococcus or Staphylococcus aureus.
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