Which of the following infections causes a non-centrally distributed rash?
(A) Epidemic typhus (B) Measles (C) Secondary syphilis (D) Typhoid
(A) Ans: A. Epidemic typhus(Ref: Harrison p1158, 1051, 1297, 1135)Centrifugal rash:Stas from face or trunk centrally a moves to extremities peripherally.Centripetal rash:Stas from extremities peripherally a moves to trunk & face centrally.Non-centripetally distributed (centrifugal) rash:Seen in epidemic typhus.Epidemic typhus:Rash begins on upper trunk on 50th day.Later becomes generalized - (Involves entire body except face, palms & soles).Initially a macular rash.Progresses to maculopapular, petechial & confluent.