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A 2-year-old child presents with a peeling, erythematous rash on the hands and feet. The mother reports that he has become ill tempered and refuses to walk about, preferring to lie in bed. Physical examination reveals an irritable, pale child with photophobia. Temperature is 98.5°F, heart rate is 80/minute, and respiratory rate is 23/minute. Tremor of the tongue is evident. Further history and follow-up evaluation reveal that the child's elder brothers have been playing with liquid mercury. Which is the most likely diagnosis?
A) Measles
B) Fifth disease
C) Kawasaki disease
D) Acrodynia
E) Photosensitivity
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in measles.....as palm and soles could be involved in severe cases while fading it desquamates and leave browny marks and photophobia could also be there because of vit a def... bit no characteristic history is there.........no koplik spots..no progression of disease
could be kawasaki disease as desqumating rash is charcetstic.....but no other features r specified to make diagnosis....... no fever >6 days,,,no lymnhnode invol.....no straberry tongue
fifth disease------mild disese .child shd not be that sick
Acrodynia........idiosyncratic reaction to mercury...........presents withgen pain, parasethesias and acral rash..............pink prurtic rash that desquamates and ulcerates
and anrexia apathy hypotonia r present irritability tremors and tachycardia present
though tachycardia is not there in this pt but rash is charcterstic and h/o of exposure i ll go for D
