Blistering rashes

Common, typically vesicular rather than bullous:

  • Varicella – tends not to affect mouth or palms/soles cf below, but more toxic
  • Coxsackie – Enteroviruses such as coxsackie nearly always involve buccal mucosa and tongue (eg Hand-Foot-Mouth). If nowhere else, Herpangina tends to be posterior mouth ie tonsils, soft palate.
  • HSV stomatitis tend to be more unwell, higher fever, gingivitis, cervical adenopathy, no cutaneous lesions.
  • Gianotti-Crosti syndrome
  • eczema herpeticum ie HSV superinfection of eczema;
  • mycoplasma (but mycoplasma has been associated with every kind of rash!)


  • disseminated zoster (starts in a dermatome, immunosuppressed);
  • disseminated HSV;
  • vaccinia

For more dramatic blistering:

  • Bullous impetigo
  • Stevens Johnson syndrome esp with plaques, conjunctivitis, lesions at mucocutaneous junctions
  • Urticaria (rarely)
  • Dermatitis herpetiformis
  • Pemphigoid (v rare in children)
  • Acrodermatitis enteropathica – genetic (recessive) disorder leading to Zn deficiency. Blistering rash esp peripheries, face and nappy; diarrhoea (Normal Zn is 10-23).

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