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Common Rashes PDF Print E-mail
Written by Dr Tom   


Many parents become very worried when their child develops a rash.

First rule:
Don't Panic! A rash is only a symptom (actually what we doctors call a "sign"), not a disease in of itself. Second, the vast majority of rashes in kids don't signify anything serious.
One exception to this is when the rash doesn't "blanch". Normally, most red rashes blanch white for a second when you apply pressure to the skin. The redness then reappears rapidly.
If the rash doesn't blanch white at all, this indicates that the spots are actually small hemorrhages in the skin. These can be pinpoint, or they may coalesce into larger red -purple areas.

There are several causes for hemorrhagic rashes, some quite serious; call the doctor immediately.
Below are some of the common rashes we see in kids:

enteroviruses - this is a group of viruses which frequently cause illness with rash in late summer & fall. Diarrhea, vomiting, fever, sore throat may be present. The rash may be just on the trunk or all over. Red spots or bumps, usually small in size, are common. No treatment is needed for enteroviruses - except fluids to prevent dehydration - and time.

scarlet fever ("scarlatina") -This is simply a strep throat with a rash. The rash does not indicate anything more serious. Fine, red bumps, on the trunk and upper arms & legs are present. The rash feels sand-papery to the touch. The face (cheeks) may be bright red. Sore throat, often with head and tummy ache are usual. Antibiotic treatment is the way to go here.

fifth disease - this is caused by a virus, especially common during the winter & spring. There may be mild fever & achy joints; often, there are no symptoms or signs except the rash. The cheeks are red ("slapped face appearance") and a lacy ("reticular") red rash is present on the upper arms, shoulders, and upper legs. The rash may be intermittent, tending to increase in the bath or with increased body temperature. This is generally a totally benign illness.

urticaria (giant hives) - large red splotches which appear, disappear, reappear, change shape; can be anywhere or all over; usually itchy. This can be a reaction to foods, medications, bug bites, viral infections, even elevated body heat from exertion or exposure to a cold environment. Usually there are no other symptoms and the rash resolves in a few days. No treatment is necessary but oral diphenhydramine (Benadryl) may help the itchiness.

impetigo - this is a strep or staph infection of the skin; tends to be red with yellowish crusting and oozing. Any "break" in the skin (bites, scratches, abrasions) may become infected with these bacteria. In kids, the area around the mouth & nose is a popular spot for this. Pustulosis is a related rash with small pustules anywhere on the skin; kids' bottoms are a prime location. Treatment is by antibiotic.

roseola - this is a viral illness, common in kids under 3 years of age. The typical story is about 3 days of high fever & irritability, then a generalized red rash all over on the 4th day. Fever is usually gone by that time. No other symptoms is the rule. Roseola is probably the most common cause of high fever - in the absence of any other symptoms -in infants & toddlers. Treatment is supportive only - fluids & fever control.

molluscum contagiosum - these are small warts; round, skin-color to slightly red, with a tiny depression in the middle. May show up anywhere, usually in groups. Spread easily but disappear in 1-2 years. Molluscum warts, like all other warts, are caused by a virus.

lip-lickers dermatitis - as the name implies, this is an irritation caused by chapped skin, often in the colder months when we turn on our heat indoors and the air is dryer. Constant licking of the skin around the mouth is irritating and worsens the condition. The skin may become infected (see impetigo above). Treatment is with a good "barrier" moisturizer ointment to coat the area; apply this often - hourly if possible. If the skin looks infected, an antibiotic ointment is appropriate.

eczema (atopic dermatitis)- this very common rash is basically areas or patches of dry, thickened, irritated skin ranging from very mild with minor involvement to very extensive, severe dermatitis. Eczema is by definition itchy. The "scratch-itch cycle" perpetuates the inflammation by releasing histamine in the skin. Treatment is aimed at interrupting this cycle by reducing the inflammation, dryness, and the tendency to scratch. Frequent use of a moisturizer is essential. Significant dermatitis usually requires something to reduce the inflammatory component such as a prescription-strength steroid. Eczema may appear at any age and is associated with allergies or asthma. Kids with eczema are more susceptible to ringworm and warts.

keratosis pilaris - this "rash" consists of numerous small bumps, most commonly on the upper outer arms, thighs, and face. Frequently seen in school-age kids & teens, No treatment is necessary except in more sever cases. This condition usually lasts years but often disappears eventually.

ringworm - this is a superficial fungus of the skin - nothing to do with worms! Consists of a red ring, with central clearing, some scaliness usually present. May be itchy. More common in kids with allergies & eczema. Treatment is with an anti-fungal cream.


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