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Viral conditions to consider for morbilliform eruptions in pediatric patients

Chikungunya reaction. Photo by: EEIM via Wikimedia Commons

Morbilliform eruptions of viral exanthems are common in the pediatric in-patient setting, and several possible diagnoses can be suspected when such eruptions present, said Catherine McCuaig MD, FRCPC during a presentation at the annual pediatric dermatology update organized by the dermatology department at St. Justine Hospital and the University of Montreal.

Dr. McCuaig is a professor at the University of Montreal and a past president of the Canadian Dermatology Association.

In an article published in the Feb. 2024 issue of The Chronicle of Skin & Allergy, Dr. McCuaig said clinicians should ask about travel history when seeing a patient as Chikungunya virus or Dengue virus can result in maculopapular eruptions.

“Has the patient travelled to the Caribbean?” asked Dr. McCuaig. “If yes, you need to think of Chikungunya or Dengue.”

Other conditions that can be suspected if morbilliform eruptions are present are inflammatory conditions, such as Kawasaki disease, as well as Multisystem Inflammatory Syndrome, with the latter condition having emerged in the COVID-19 pandemic, explained Dr. McCuaig.

With respect to multisystem inflammatory syndrome in children (MIS-C), which was first identified in the early days of the COVID-19 pandemic, the condition differs from Kawasaki disease as it tends to affect children at an older age. Where Kawasaki disease usually appears in children less than five years of age, MIS-C appears typically in children aged five to 13. 

“It [MIS-C] appears in children, by definition under 21 years of age, and presents with a fever with multi-organ involvement and evidence of very significant inflammation,” said Dr. McCuaig.

—with files from Chronicle Correspondent Louise Gagnon. Read a digital edition of The Chronicle of Skin & Allergy here. To apply for a complimentary* subscription or to receive a sample copy, please email with your contact information.


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