A rash is the reaction of skin to an allergen, infection or drug. Most of them are caused by self-limiting illness and go away with time even without treatment, but some causes of rashes are life-threatening. So, it is important to identify rashes in your child and see a doctor promptly when you suspect a serious underlying cause.
Many rashes often look very similar because skin can react in so many ways. In such cases, the history and associated symptoms help in making a diagnosis.
How To Identify Rashes In Children
Rashes due to Infection With Virus or Bacteria
Chickenpox rash is preceded by sore throat, fever and tiredness, and appears first on the face and trunk and then spreads to both limbs. It is very itchy. Initially a tiny reddened area develops with a central blister that ruptures after a day or two leaving a scab which falls off in 2 to 3 days. Consult a doctor if the tip of the nose or eyes are involved.
Measles rash develops after 3 or 4 days of cough, nasal congestion, redness in eyes and fever. It changes colour from reddish to brownish, affecting the face first, and spreading to involve the entire body. It is itchy and lasts for a week. Watch out for complications such as ear or lung infection.
Rubella rash develops along with fever, headache, joint pains and conjunctivitis. It is light red or pinkish in colour and mildly itchy. Rubella is mild without specific treatment.
Rash of scarlet fever is reddish and rough like sandpaper. Cheeks may appear flushed. Soles and palms are usually spared. Child will have sore throat, fever, headache and upset stomach. A doctor needs to be consulted.
A child with fifth disease will have initially sore throat, nasal congestion and fever. The rash appears with cheeks bright red. It spreads to other parts, particularly the arms. The disease is self-limiting.
Rash of roseola infantum is preceded by high fever. There are small, flat or raised, pink lesions appearing on the trunk and spreading to the limbs. Only symptomatic treatment is advised.
In impetigo, a bacterial infection of skin, small and superficial blisters develop, which rupture leaving behind patches of red skin covered by a crust. There could be itching. See a doctor.
Rashes due to Fungi and Parasites
Scabies rash is very itchy worse after bath or at night, between the fingers, in armpits and on inner side of arms and wrists. Rash of ringworm is red, slightly itchy, oval and growing in size with a raised border. Athlete’s foot manifests with a highly itchy rash present between toes.
Child will look very ill. If fever is associated with red or purple rashes which are small and flat that do not fade when pressed (petechiae), a doctor should be consulted immediately as it could be bacterial sepsis. The petechial rash could appear like large bruises.
In Rocky Mountain spotted fever there is high fever of sudden onset, with fatigue and abdominal pain, and history of outdoor activity making tick bite likely. The rash appears as reddish spots on ankles and wrists, spreading to trunk but spares the face. They blanch on pressure. Child needs to be hospitalized.
A similar history and rash along with neck stiffness and pain can signify Lyme disease. Kawasaki disease presents with fever, red eyes, neck swellings, red or swollen fingers and toes with peeling of skin, and red lesions, flat or raised, and blisters on the hands and the feet.
Toxic shock syndrome presents with high fever of sudden onset, body aches, sore throat and a rash resembling a sunburn with peeling of skin on soles and palms.