Hello and welcome to the Zero to Finals podcast. My name is Tom and in this episode I'm going to be

talking to you about non-blanching rashes in children. And you can find written notes on this topic at

zero-definals.com slash non-blanching rashes or in the dermatology section of the zero-definals

pediatrics book.

So let's get straight into it.

Non-blanching rashes are caused by bleeding under the skin.

Patikiye are small, less than 3mm,

non-blanching red spots on the skin caused by burst capillaries.

Popura are larger 3 to 10mm non blanching red purple macules or papules

created by leaking of blood from vessels under the skin.

Any child presenting with a non blanching rash needs immediate investigation for the underlying cause.

The most concerning differential diagnosis is meningococcal septicemia, which is a medical emergency.

Patients with features of sepsis need immediate management for life-threatening meningococcal sepsis.

Let's talk about the differential diagnosis. We've already mentioned meningococcal sepsis. Let's talk about the differential diagnosis.

We've already mentioned meningococcal septicemia or other bacterial sepsis.

This presents with a feverish, unwell child.

Any features of meningococcal septicemia need emergency management with immediate antibiotics.

Septuosemia can lead to significant morbidity and mortality if treatment is delayed. Henok-S-Len-Purpura, or HSP, typically presents as a

purpuric rash on the legs and the buttocks, and there may be associated abdominal or joint pain.

Idiopathic thrombocytopinic purpura, or ITP, develops over several days in an otherwise

well child. Acute leukemia presents with a gradual development of patechiae, potentially

with other signs such as

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