Fourth disease
Classification and external resources
ICD-10	B09.
ICD-9	057.8

Dukes' disease or fourth disease is an exanthem.

It is named for Clement Dukes.^[1][2]

Some of these eruptions are characteristic of the causative virus, but in most cases one must be satisfied with the diagnosis of viral rash.

It was never associated with a specific pathogen,^[3] and the terms "fourth disease" and "Dukes' disease" are rarely used today.

In 1979 Keith Powell proposed equating it with the condition currently known as Staphylococcal scalded skin syndrome.^[4][5]

[edit] Presentation

Signs and symptoms may include fever, nausea, vomiting, and diarrhea, along with typical viral symptoms of photophobia, lymphadenopathy, sore throat, and possibly encephalitis. The rash may appear at any time during the illness. It is usually generalised. The rash consists of erythematous maculopapules with areas of confluence. They may be urticarial, vesicular, or sometimes petechial. The palms and soles may be involved. The eruptions are more common in children than in adults. Usually, the rash fades without pigmentation or scaling.

[edit] References

v • d • e Exanthema Viral RNA virus Measles (1st disease) · Rubella (3rd disease) DNA virus Slap cheek (5th disease) · Roseola (6th disease) · Chickenpox Obsolete Duke's disease (4th disease) Bacterial Scarlet fever (2nd disease)