Dukes' disease, named after Clement Dukes, also known as fourth disease or Filatov-Dukes' disease (after

Nil Filatov Nil Fyodorovich Filatov (russian: Нил Фёдорович Фила́тов, , or , – ) was a medical doctor who is considered the founder of Russian paediatrics. His nephew Vladimir Filatov was a prominent ophthalmologist. Career Having gra ...

), is an

exanthem An exanthem is a widespread rash occurring on the outside of the body and usually occurring in children. An exanthem can be caused by toxins, drugs, or microorganisms, or can result from autoimmune disease. The term exanthem is from the Greek ...

. It is distinguished from measles or forms of rubella, though it was considered as a form of viral rash. Although Dukes identified it as a separate entity, it is thought not to be different from scarlet fever caused by exotoxin-producing ''

Streptococcus pyogenes ''Streptococcus pyogenes'' is a species of Gram-positive, aerotolerant bacteria in the genus '' Streptococcus''. These bacteria are extracellular, and made up of non-motile and non-sporing cocci (round cells) that tend to link in chains. They ...

'' after Keith Powell proposed equating it with the condition currently known as

staphylococcal scalded skin syndrome Staphylococcal scalded skin syndrome (SSSS) is a dermatological condition caused by ''Staphylococcus aureus''. Signs and symptoms The disease presents with the widespread formation of fluid-filled blisters that are thin walled and easily rupture ...

in 1979. It was never associated with a specific pathogen, and the terminology is no longer in use. However, a mysterious rash of unknown cause in school children often gives rise to the question of whether it could be Dukes' disease.

Signs and symptoms

Signs and symptoms may include

fever Fever, also referred to as pyrexia, is defined as having a temperature above the normal range due to an increase in the body's temperature set point. There is not a single agreed-upon upper limit for normal temperature with sources using val ...

nausea Nausea is a diffuse sensation of unease and discomfort, sometimes perceived as an urge to vomit. While not painful, it can be a debilitating symptom if prolonged and has been described as placing discomfort on the chest, abdomen, or back of the ...

vomiting Vomiting (also known as emesis and throwing up) is the involuntary, forceful expulsion of the contents of one's stomach through the mouth and sometimes the nose. Vomiting can be the result of ailments like food poisoning, gastroenteri ...

, and

diarrhea Diarrhea, also spelled diarrhoea, is the condition of having at least three loose, liquid, or watery bowel movements each day. It often lasts for a few days and can result in dehydration due to fluid loss. Signs of dehydration often begin w ...

, along with typical viral symptoms of sensitivity to light,

enlarged lymph nodes Lymphadenopathy or adenopathy is a disease of the lymph nodes, in which they are abnormal in size or consistency. Lymphadenopathy of an inflammatory type (the most common type) is lymphadenitis, producing swollen or enlarged lymph nodes. In cl ...

sore throat Sore throat, also known as throat pain, is pain or irritation of the throat. Usually, causes of sore throat include * viral infections * group A streptococcal infection (GAS) bacterial infection * pharyngitis (inflammation of the throat) * to ...

, and possibly brain inflammation. The rash may appear at any time during the illness. It is usually generalised. The rash consists of

erythematous Erythema (from the Greek , meaning red) is redness of the skin or mucous membranes, caused by hyperemia (increased blood flow) in superficial capillaries. It occurs with any skin injury, infection, or inflammation. Examples of erythema not assoc ...

maculopapules with areas of confluence. They may be

urticarial Hives, also known as urticaria, is a kind of skin rash with red, raised, itchy bumps. Hives may burn or sting. The patches of rash may appear on different body parts, with variable duration from minutes to days, and does not leave any long-lasti ...

, vesicular, or sometimes petechial. The palms and soles may be involved. The eruptions are more common in children than in adults. Usually, the

rash A rash is a change of the human skin which affects its color, appearance, or texture. A rash may be localized in one part of the body, or affect all the skin. Rashes may cause the skin to change color, itch, become warm, bumpy, chapped, dry, c ...

fades without

pigmentation A pigment is a colored material that is completely or nearly insoluble in water. In contrast, dyes are typically soluble, at least at some stage in their use. Generally dyes are often organic compounds whereas pigments are often inorganic compoun ...

Signs and symptoms

Diagnosis

References

External links