Petechial hemorrhage, Rocky Mountain Spotted Fever
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The rash of Rocky Mountain Spotted Fever (RMSF) is a petechial rash, and it characteristically involves cooler areas of the body, such as the hands and feet. Petechial hemorrhages are small, pinpoint hemorrhages, often around hair follicles (hence, the name "Spotted Fever"). They are caused by leakage of RBCs from dermal capillaries.