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Classification according to ICD-10
R21 Rash and other non-specific skin eruptions
ICD-10 online (WHO version 2019)
Allergic rash

An exanthem (from Greek exantheo , 'I bloom') is an acute rash on the skin. It often occurs in general infectious diseases such as measles , rubella , chickenpox , scarlet fever , typhoid , hand-foot-mouth disease . A rash can also be the result of a drug intolerance ( drug rash ) or a symptom of an allergic reaction . A rash is also a major symptom of secondary syphilis and a symptom of Still's disease , a juvenile form of rheumatoid arthritis . A vitamin B2 deficiency can also lead to a rash. Rarely, exanthema can also occur as an undesirable side effect of medication, e.g. B. Levofloxacin .

Medical history

A historical classification of the diseases with rash that v. a. occur in childhood, consisted in a numbering of the identified childhood diseases and developed until around 1910 with the definition of the sixth disease. It is only rarely used for the fifth ( rubella ) and sixth illness ( three-day fever ).

First illness: measles

Measles was differentiated from other diseases from around the 10th century, with typhus and scarlet fever not being differentiated until the 15th century. A first more detailed description was given by Dönert in 1641.

Second disease: scarlet fever

Scarlet fever was first distinguished from measles in 1553.

Third disease: rubella

Rubella was first recognized as a disease in its own right at the Medical Congress in 1881.

Fourth disease: Filatov's or Dukes' disease

This clinical picture was described by Filatow in 1885 and Dukes, who called it the "fourth disease", in 1900. This disease (also called Filatow-Dukes disease and Rubeola scarlatinosa ) is no longer viewed as a separate entity, but it is assumed that the forms described are either atypical scarlet fever or rubella infections, or staphylococcal scalded skin syndrome . As early as 1960, it was considered likely that the fourth disease was mild cases of scarlet fever, in some cases rubella with a scarlatiniform rash, and less often rashes of other causes.

Fifth disease: rubella

From around 1905 this disease was referred to as an independent clinical picture, today's name is ringlet rubella .

Sixth illness: three-day fever

This form was described by Zahorsky in 1910 and is known as three-day fever .

See also

Individual evidence

  1. a b Without naming the author: Fourth, Fifth, and Sixth. In: Britical Medical Journal. November 1974, p. 429.
  2. D. Sennert: De variolis, & morbillis. In: Sennert D (Ed.): De febribus libri quator. Editio novissima. Cui accessit fasciculus medicamentorum contra pestem. Libri IV. De peste, pestilentibusque ac malignis febribus. (Latin). In: Venice: Franciscum Baba. 1641, pp. 177-186.
  3. GF Ingrassia: De tumoribus praeter naturam tomus primus. (Latin). Matthaeus Cancer, Naples 1553 ( digitized ).
  4. ^ W. MacCormac, GH Makins, Under Secretaries of the Congress (eds.): Transactions of the International Medical Congress. Seventh session, held in London, August 2nd to 9th, 1881 . Vol 4., JW Kolkmann, London 1881, pp. 14-34.
  5. Karl Wurm, AM Walter: Infectious Diseases. In: Ludwig Heilmeyer (ed.): Textbook of internal medicine. Springer-Verlag, Berlin / Göttingen / Heidelberg 1955; 2nd edition, ibid. 1961, pp. 9–223, here: p. 66.
  6. David M. Morens, Alan R. Katz: The "Fourth Disease" of Childhood: Reevaluation of a Nonexistent Disease. In: American Journal of Epidemiology. September 1991, Vol. 134, No. 6, pp. 628-640, PMID 1951267 .
  7. Martin E Weisse: The fourth disease, 1900-2000 . In: The Lancet . tape 357 , no. 9252 , 2001, p. 299–301 , doi : 10.1016 / S0140-6736 (00) 03623-0 .
  8. Karl Wurm, AM Walter: Infectious Diseases. 1961, p. 66.
  9. L. Cheinisse: Une cinquieme maladie eruptive: le megalerytheme epidemique. (French) In: Semaine Med. 1905; 25, pp. 205-207.
  10. ^ J. Zahorsky: Roseola infantilis. In: Pediatrics. 1910; 22, pp. 60-64.