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A CLINICIAN’S GUIDE TO DERMATOLOGIC DIFFERENTIAL DIAGNOSIS, VOLUME 1



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[Encyclopedia of Differential Diagnosis in Dermatology] Paul Schneiderman, Marc E. Grossman - A Clinician\'s Guide to Dermatologic Differential Diagnosis, Volume 1 The Text (Encyclopedia of Differential Diagnosis in D

180
A CLINICIAN’S GUIDE TO DERMATOLOGIC DIFFERENTIAL DIAGNOSIS, VOLUME 1
Schneiderman page 100-200.qxd 5/16/2006 6:49 PM Page 180


Psittacosis – morbilliform eruption 
Br Med J 289:510–511,
1984; rose spots AD 120:1227–1229, 1984; erythema nodosum
J Hyg 92:9–19, 1984; erythema multiforme Br Med J
2:1469–1470, 1965; disseminated intravascular coagulation AD
120:1227–1229, 1984
Q fever – 
Coxiella burnetii; red macules, morbilliform, papular,
urticarial, and purpuric eruptions 
JAAD 49:363–392, 2003;
Pediatr Inf Dis J 19:358, 2000
Rat bite fever (
Streptobacillus moniliformis (pleomorphic
facultative anaerobic bacillus) or 
Spirillium minor (Soduku)) –
macular, petechial, or morbilliform widespread exanthem;
palmoplantar rash; arthralgia, septic arthritis and chronic
arthritis; Haverhill fever (raw milk) – papules, crusted papules,
vesicles, pustules; chronic abscesses
MMWR 53:1198–1202,
2005; Cleveland Clin Q 52 (2):203–205, 1985; Pediatr Clin N
Am 26:377–411, 1979
Relapsing fever (tick-borne relapsing fever) – 
Ornithodoros soft
ticks transmitting 
Borrelia hermsii, B.turicata, or B. parkeri; 1–2 cm
rose-colored macules, papules, petechiae, purpura, facial
flushing; arthralgias, iritis, myalgia; found in cabins of coniferous
forest of western United States or caves of southwest US 
JAAD
49:363–392, 2003; diffuse macular rash Tyring p.438, 2002
Rickettsial pox – sparse papulovesicular exanthem (Kew
Gardens spotted fever) 
JAAD 47:766–769, 2002; NY Med
2:27–28, 1946
Rocky Mountain spotted fever (
Rickettsia rickettsii) – initially
blanching pink macules, or morbilliform eruption of wrists and
ankles; soon spreads to face, trunk, and extremities; palms and
soles involved; becomes purpuric with acral gangrene 
Cutis
70:165–168, 2002; JAAD 2:359–373, 1980
Rose spots
Brucellosis
Leptospirosis
Meningitis
Miliary tuberculosis
Psittacosis
Rat bite fever
Salmonella – typhoid fever AD 105:252–253, 1972; Lancet
1:1211–1213, 1975; NEJM 340:869–876, 1999
Shigellosis
Trichinosis
Roseola infantum (human herpesvirus 6) (possibly human
herpes virus 7) 
NEJM 352:768–776, 2005; Arch Dis Childhood
72:518–519, 1995) – rose–pink macules start on neck and
trunk, then spread to face and extremities; rarely vesicular
Tyring p.3,201–203, 2002; Rook p.998,1025, 1998, Sixth
Edition; BJD 132:614–616, 1995
Rotavirus exanthem – pink–red 2–3-mm macules or papules on
the trunk on days 3–6 of the illness 
Skin and Allergy News
30:38,1999; AD 121:253–254, 1985
Rubella – macular exanthem 
Tyring p.3, 522–523, 2002; Rook
p.998, 1998, Sixth Edition
Rubeola 
Tyring p.3, 2002
Scabies, including crusted (Norwegian) scabies 
Rook p.1069,
1998, Sixth Edition
Scarlet fever – 
Streptococcus pyogenes; scarlatiniform
(sandpaper) rash, erythema marginatum 
JAAD 39:383–398,
1998
Schistosomiasis – schistosomal dermatitis – identical to
swimmer’s itch 
Dermatol Clin 7:291–300, 1989
Scrub typhus (
Rickettsia tsutsugamuchi) (mites) – headache
and conjunctivitis; eschar with black crust; generalized macular
or morbilliform rash 
Clin Inf Dis 18:624, 1994; JAAD 2:359–373,
1980
Seabather’s eruption – larvae of 
Scyphomedusa, Linuche
unguiculata (thimble jellyfish) JAAD 44:624–628, 2001
Seaweed dermatitis
Shigellosis – rose spots 
Am J Dis Child 119:152–154, 1970
Sindbis – arbovirus; fever, rash, arthritis; Europe, Asia, Africa,
Australia 
Tyring p.399, 2002
Smallpox – morbilliform exanthem as initial cutaneous
manifestation 
Cutis 71:319–321, 2003
Smallpox vaccination – with erythema multiforme 
Clin Inf Dis
37:251–271, 2003; eczema vaccinatum Clin Inf Dis 37:251–271,
2003
Staphylococcal scalded skin syndrome
Staphylococcal scarlet fever 
Rook p.1104,1127, 1998, Sixth Edition
Streptococcal toxic shock syndrome – morbilliform or
scarlatiniform exanthem; painful localized edema and erythema;
progression to vesicles and bullae 
Textbook of Neonatal
Dermatology, p.189, 2001; Rook p.1107, 1998, Sixth Edition
Strongyloides stercoralis – disseminated strongyloidiasis with
morbilliform exanthem 
JAAD 49:S57–60, 2003
Swimmer’s itch
Syphilis, secondary – macular syphilid 
Rook p.1245, 1998,
Sixth Edition; morbilliform or papular J Clin Inf Dis
21:1361–1371, 1995; roseolar eruptions Rook p.2079, 1998,
Sixth Edition
Tick typhus (Boutonneuse fever, Kenya tick typhus, African and
Indian tick typhus) (ixodid ticks) – small ulcer at site of tick bite
(tache noire) – black necrotic center with red halo; pink
morbilliform eruption of forearms, then generalizes, involving
face, palms, and soles; may be hemorrhagic; recovery
uneventful 
JAAD 2:359–373, 1980
Togavirus – morbilliform eruption 
Rook p.998, 1998, Sixth Edition
Toxic shock syndrome, either streptococcal or staphylococcal –
widespread macular erythema, scarlatiniform, and
papulopustular eruptions; occasional vesicles and bullae;
edema of hands and feet; mucosal erythema; second week
morbilliform or urticarial eruption occurs with desquamation
at 10–21 days; diffuse erythema 
Clin Inf Dis 32:1470–1479,
2001; Rook p.2079, 1998, Sixth Edition; JAAD 39:383–398,
1998; Rev Infect Dis 11 (Suppl 1):S1–7, 1989; JAAD
8:343–347, 1983
Toxoplasmosis (
Toxoplasma gondii) – maculopapular eruption
AD 136:791–796, 2000; macular, morbilliform, purpuric
exanthemata; scarlatiniform desquamation 
Rook p.1422, 1998,
Sixth Edition
Trichinosis – periorbital edema, conjunctivitis; transient
morbilliform eruption, splinter hemorrhages 
Can J Public Health
88:52–56, 1997; Postgrad Med 97:137–139, 143–144, 1995;
South Med J 81:1056–1058, 1988
Trichosporon beigelii Medicir GS 268:1986
Trypanosomiasis – African; edema of face, hands, feet with
transient red macular, morbilliform, petechial or urticarial
dermatitis; circinate, annular of trunk 
Rook p.1407–1408, 1998,
Sixth Edition; AD 131:1178, 1995; American – cutaneous
inoculation (inoculation chagoma); edema with exanthems 
Rook
p.1409–1410, 1998, Sixth Edition
Tularemia – 
Franciscella tularensis (non-encapsulated gram-
negative coccobacillus); transmitted in tick feces; skin, eye,
respiratory, gastrointestinal portals of entry; ulceroglandular,
oculoglandular, glandular types; typhoidal, pneumonic,
oropharyngeal, and gastrointestinal types; toxemic stage
heralds macular, generalized morbilliform eruption, vesicular,
pustular, nodular or plaque-like secondary eruption 
JAAD
49:363–392, 2003; erythema multiforme-like rash, crops of red
nodules on extremities
Cutis 54:279–286, 1994; Medicine
54:252–269, 1985; vesiculopapular lesions of trunk and
extremities 
Photodermatology 2:122–123, 1985

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