I recently had this case with a provider who struggled to find the correct diagnosis. There’s an old saying about rashes in the ER: “if it’s wet, dry it – and if it’s dry, wet it”. Which essentially boils down to: most benign rashes in the ER can be treated with steroids. Identifying a precise diagnosis is often impractical and can be deferred to a dermatologist for biopsy or just a primary care provider to follow up . However, this is one example of a rash that everyone who works in the ER should be familiar with and able to diagnose.
A mother brings in her young child for fever and rash on the face and torso.
Diagnosis: COVID. No!
Not everything is COVID.
This is a classic presentation of impetigo, which starts as a red itchy sore and as it heals, a ‘honey colored’ crusty scab forms over the sore. It mostly affects children aged 2-5 and is found on exposed skin such as around the nose and mouth.
Most cases improve with topical antibiotics but in rare instances oral meds may be necessary.
So the next time you see this rash, you can greet them like a boss:
