Dukes' disease

From Wikipedia, the free encyclopedia
Jump to navigation Jump to search
Fourth disease
SpecialtyInfectious disease Edit this on Wikidata

Dukes' disease, named after Clement Dukes,[1] also known as fourth disease[2] or Filatov-Dukes' disease (after Nil Filatov),[3] is an exanthem. It is distinguished from measles or forms of rubella, though it was considered as a form of viral rash.[2] Although Dukes identified it as a separate entity, it is thought not to be different from scarlet fever caused by exotoxin-producing Streptococcus pyogenes after Keith Powell proposed equating it with the condition currently known as staphylococcal scalded skin syndrome in 1979.[2][4]

It was never associated with a specific pathogen,[5] and the terminology is no longer in use.[2] However, a mysterious rash of unknown cause in school children often gives rise to the question of whether it could be Dukes' disease.[6]

Signs and symptoms[edit]

Signs and symptoms may include fever, nausea, vomiting, and diarrhea, along with typical viral symptoms of sensitivity to light, enlarged lymph nodes, sore throat, and possibly brain inflammation; the rash may appear at any time during the illness. It is usually generalised; the rash consists of erythematous maculopapules with areas of confluence. They may be urticarial, vesicular, or sometimes petechial; the palms and soles may be involved. The eruptions are more common in children than in adults. Usually, the rash fades without pigmentation or scaling.



  1. ^ Dukes, C (30 June 1900). "On the confusion of two different diseases under the name of rubella (rose-rash)". The Lancet. 156 (4011): 89–95. doi:10.1016/S0140-6736(00)65681-7.
  2. ^ a b c d Weisse, ME (31 December 2000). "The fourth disease, 1900-2000". The Lancet. 357 (9252): 299–301. doi:10.1016/S0140-6736(00)03623-0. PMID 11214144.
  3. ^ Dukes-Filatov disease at Who Named It?
  4. ^ Powell, KR (January 1979). "Filatow-Dukes' disease. Epidermolytic toxin-producing staphylococci as the etiologic agent of the fourth childhood exanthem". Am. J. Dis. Child. 133 (1): 88–91. doi:10.1001/archpedi.1979.02130010094020. PMID 367152.
  5. ^ Morens, DM; Katz, AR (September 1991). "The "fourth disease" of childhood: reevaluation of a nonexistent disease". Am. J. Epidemiol. 134 (6): 628–40. PMID 1951267.
  6. ^ "Dukes' return? On the trail of the mysterious rash in school children". Healio, Infectious Diseases in Children. April 2002. Retrieved 19 August 2013.

External links[edit]