Iododerma and bromoderma. Iodides and bromides are drugs that can cause severe adverse cutaneous reactions, and of these, the worst are acneiform, furuncular, carbuncular, chancriform, pyodermatous, or granulomatous. Iodides and bromides are widely distributed, not only in foods and in the environment but also in proprietary and formally prescribed medicaments. These figures are of still relatively minor consequences of adverse reactions from the two halides, of which bromides are usually worse than iodides. Lesions like those of acne or folliculitis caused by an iodide are shown.
Erythema infectiosum (fifth disease). Erythema infectiosum is a mild childhood disease that is caused by human parvovirus B19. This condition develops after a mean incubation period of 14 days. There are few if any prodromal symptoms. The rash evolves in three clinical stages. The first stage is characterized by the abrupt appearance of a bright-red malar blush. The appearance is so startling that it has been given the suggestive description of “slapped cheeks”. During the second stage, the facial rash begins to fade, and a maculopapular, urticarial, or morbilliform exanthem develops on the extremities and trunk. Pruritus may be present.
Hand-foot-mouth disease. This common and benign viral disease of childhood is usually caused by the A16 strain of coxsackievirus, although other strains of the same virus have been implicated. It most often occurs in late summer and early fall. The prodrome consists of low-grade fever and malaise. Shortly thereafter, vesicular lesions arise on the soft palate, tongue, buccal mucosa, and uvula. The lips are usually spared. Occasionally, these lesions may be painful and cause some difficulty in eating. The cutaneous lesions develop 1 or 2 days after those in the mouth. They consist of asymptomatic round or oval vesiculopustules that evolve into superficial erosions. The edges of the palms and soles are a favored location.