[box border=”full”]Rashes are very common in infants and children and can be very alarming. However they are rarely serious in a country like Australia. Rashes can be divided into those that occur in association with an illness and those that are more like a dermatitis or allergic reaction. There are rashes that ocassionally inidicate either a serious disease of infection. Fortunately these are very rare.[/box]
At the top of the list of causes are viral rashes. In this country and most countries where immunisation rates are high the most common cause are simple viruses that can cause an infant to have cold like symptoms such as a runny nose cough and temperature. A mild rash can develop on the trunk which can sometimes be spotty and will look particularly alarming after a bath or when the child is hot. These rashes usually do not bother the child and they can last for a number of days until they slowly subside. There is no treatment needed. The spots can be very feint and small and they disappear when pressed.
One of the most common rashes seen is called Roseola Infantum. This rash has a unique presentation. It can occur at any age from 4 months. The infant will often have a high temperature and is quite irritable. There is usually no runny nose, no cough, and no other symptoms. After 48 to 72 hours the fever will subside and then within hours a rash will appear which can be on the face and trunk. This rash will last for several days and does not bother the child. The only other findings noted are usually swollen glands at the back of the neck and sometimes some swelling of the eyelids, This virus is common and is not serious though in those who are prone to febrile convulsions it can trigger these.
Other Rashes associated with infections.
This is a rash associated with a bacteria called Group A streptococcus. It is common in school aged children and used to be a serious illness. Over the last century the organism has become less aggressive and with the advent of antibiotics this illness is easily treated. It occurs shortly after a child – usually over the age of 5 years contracts a tonsillitis illness.
Is It Measles ?
Measles has recently increased dramatically. This is due to cases returning from overseas and infecting those who are unimmunised. The child who has measles is unwell. Symptoms include high temperature, a painful hacking cough, nasty conjunctivitis and striking rash. The diagnosis is by blood test and these children will need urgent hospitalisation. In 2012 the WHO estimated 122,000 children died of measles. These occur in nations where there is no immunisation.
Is it Meningococcus ?
This rash is also quite striking. But the rash is nearly always in association with a very sick child. The other signs include high fever, vomiting, headache, and lethargy bordering on unconsciousness, The child will be unable to walk and it is quite clear that urgent medical attention is needed. Having said this it is very rare. There are vaccinations against the most common strains which are called B and C. The Meningococcus B vaccine is new and called Bexsero. It is not yet on the immunisation schedule, is recommended but expensive.
Allergic and Dermatitis
These rashes tend to be itchy. The most common allergic type of rash is called hives. The medical name for this is urticaria. Hives causes a bumpy itchy rash like lots of fresh mosquito bites. The causes of allergic reactions range from simple viruses through to contact with food or medications. Although the most commonly the trigger is not found and hives settles after a few days. It responds to antihistamines.
Dermatitis is very common. This produces a rough itchy red rash. Eczema is the name given to this condition and it occurs in infants. There is a separate information page on the infant problems part of the web page.
There are a number of other common rashes seen. Impetigo or school sores looks like scabs that seem to pop up in places where there was no history of trauma. This is common in summer and needs to be treated with an antibiotic ointment or medication.
Scabies – is also common. This rash is similar to eczema and is intensely itchy. It can occur anywhere on the body. It is infectious and caused by a mite which burrows under the skin. The child is usually quite distressed by the itch which can occur on the wrists, fingers, genitals and under the arms. Often the face is not involved.
There are a number of rashes that are associated with other ailments. Some children will get a rash on the backs of the legs called Henoch Schonlein Purpura. This is quite striking and is associated with a number of other symptoms. There are rashes that can occur with arthritis and other illnesses. These are rare
As a rule of thumb if the rash is bothering the child, either because he or she is unwell, or the rash is itchy then it should be seen to.