Pleomorphism can be seen in which disease?

RRB Nsg. Superintendent-20 July 2019 (Shift-3rd)

Medical & Surgical Nursing

Easy

Appeared in: RRB Nsg. Superintendent-20 July 2019 (Shift-3rd)

Explanation

Pleomorphism in a clinical rash refers to the simultaneous presence of lesions in different stages of development (e.g., spots, blisters, and scabs all at once).
Chickenpox (Varicella) is the classic disease that presents with a pleomorphic rash.
This occurs because new crops of lesions appear over several days, leading to a mixture of fresh and healing spots in the same area of the body.

Option A: The clinical rash of Rubella is a uniform maculopapular rash that spreads from the face downwards. It does not show multiple stages of lesions simultaneously.
Option B: Typhoid fever is characterized by 'rose spots,' which are uniform, faint, salmon-colored macules. The rash is not pleomorphic.
Option D: The rash in Dengue fever is typically a diffuse erythematous or petechial rash. It does not exhibit the multiple, evolving stages of a pleomorphic rash.

Visual 1: Image: A close-up photograph of skin affected by chickenpox, clearly showing red spots (macules), raised bumps (papules), fluid-filled blisters (vesicles), and healing scabs (crusts) all in the same area to illustrate pleomorphism.
Visual 2: Infographic: A comparative chart showing the distinct rash patterns of Chickenpox, Measles, Rubella, and Dengue fever, highlighting key differences in appearance, distribution, and evolution.

Clinical Relevance

Nursing practice connection: Knowing Identification of infectious diseases based on the characteristics of their clinical rash, specifically the concept of pleomorphism helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Recognizing a pleomorphic rash is a critical diagnostic skill for a nurse, as it strongly suggests chickenpox. This requires immediate implementation of airborne and contact precautions to prevent transmission to other patients, especially the immunocompromised.
Patient education is a key nursing role. The nurse must advise the patient and family not to scratch the intensely itchy lesions to prevent secondary bacterial infections and permanent scarring.
What if? If a patient who has received the varicella vaccine presents with a rash, the nurse should still consider 'breakthrough chickenpox.' This form is usually milder, with fewer lesions that may not be classically pleomorphic, but the patient is still contagious and requires infection control measures.

How to Approach the Question

First, define the key term in the question: 'Pleomorphism'. In the context of a rash, this means having lesions of multiple different types or stages at the same time.
Think of the classic presentation of a pleomorphic rash: spots, bumps, blisters, and scabs all present together.
Review the options provided and recall the typical rash associated with each disease.
Rubella causes a uniform pink rash. Typhoid causes uniform 'rose spots'. Dengue causes a diffuse red or petechial rash.
Identify that Chickenpox is the only disease listed that is famous for its rash appearing in crops, resulting in the classic pleomorphic appearance.
Select Chickenpox as the correct answer based on this unique characteristic.

Concept Tested & Keywords

Concept Tested: Identification of infectious diseases based on the characteristics of their clinical rash, specifically the concept of pleomorphism.
Stem keywords: Pleomorphism, disease
Lead-in keywords: can be seen in

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