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Mucocutaneous lymph node syndrome, or Kawasaki disease, is a febrile, exanthematous disease of children that has potentially fatal complications. The most important complication is the development of aneurysms in the coronary arteries, which may thrombose or occasionally, rupture and cause severe morbidity or death. Criteria for the diagnosis of Kawasaki disease have been developed that may help the clinician make the diagnosis and prevent complications. The major criteria include fever, skin eruption, ocular changes, oral changes, changes in the extremities, and lymphadenopathy. Prognosis may be evaluated by the clinical picture and cardiac work-up with echocardiogram.

The numerous viral skin diseases that affect children present a diagnostic challenge to the clinician. Most of these diseases may be conveniently grouped according to the clinical appearance of the exanthem as maculopapular, petechial, papular, or vesicular. In some situations, viral infection may be difficult to differentiate clinically from nonviral disease; thus, extensive laboratory evaluation is sometimes necessary to pinpoint the virus involved. Nonviral disease should be considered in the differential diagnosis of a patient with skin eruptions, especially of the maculopapular type. Common nonviral causes include Kawasaki disease, toxic shock syndrome, and drug reactions.

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