Sorting out pediatric rashes
Written by: Dr.Ravneet Dhaliwal
Rashes often put parents in panic and confusion, understandbly so, since they are so visual. Let us review some of the common rashes that do not need treatment but only need supportive care at home that we see in Children and go over when is it important to seek emergency care evaluation.
Hand Foot Mouth
(Coxsackie Virus) -HFM- usually common in children under 5, causes sores in the back of the throat, red blister like rash on hands, red small spots on the palms and soles sometimes. Small red spots, sometimes blisters can also be seen elsewhere on the body. It is self-limiting. It is contagious, spread through saliva, fluid from blisters, stool, or respiratory droplets. It goes away on its own in about 7-10days (about 1 and a half weeks). Over-the-counter pain relievers, like ibuprofen, and cold popsicles and drinks can help relieve pain.
Can be seen in Adults and Pediatrics. It is caused by anything that irritates the dermis layer. It is a red rash which can be dry, cracked, bumpy, blisters, swollen. Yes, some different variations hence sometimes can be confusing for patients or parents. But then it is very itchy, sometimes severe itching which can help narrow the diagnosis. POISON IVY is one type of Contact Dermatitis, a lot of other agents can cause Contact dermatitis. Over the counter mild corticosteroids, anti-itch medications can help clear it. It can take 2-4 weeks to clear and for the Dermis layer to heal. Contact a doctor if rash worsens or spreads around the eye or nasal passages.
Eczema! Our Favorite!
Common in Infants and Children and usually gets milder with age. It is a rash where the immune system attacks the skin. Usually present on inside of elbows, behind the knees, creases, or wrists. Rash is dry, cracked, scaly, leathery, spots of lighter or darker skin. There is no cure but many different management options, fortunately. Pediatricians and GP can help manage it with different options based on severity. One of the important pieces is to keep skin moisturized, figure out the causes of flare ups such as (heat, cold, allergens) and avoid those.
Most common in Infants. Rash is usually flaky, oily scalp with yellow crust. It mostly does not bother babies. It can be caused by too many oil glands and a type of yeast that is found on the skin. It is not contagious and usually clears on its own over a few weeks or months. Gentle washing with mild shampoo and rubbing it off with a soft brush.
May occur at any age. Blisters In the mouth and/or lips. Sometimes painful sores, swollen gums. Infection is sometimes called Oral herpes. It can be caused by hand foot mouth rash, but stomatitis is only found around the mouth.
It can be treated with over-the-counter pain medicine and lots of hydration. If hydration becomes a concern, then patients should seek medical evaluation and care. Sometimes Rx medication is needed as well.
Diaper Rash (Diaper dermatitis or Diaper candidiasis
Most commonly in infants and children under the age of 2. It looks red with patches and inflamed in the diaper area. It is painful and irritating. Since the area is moist and closed most of the time, fungus can cause infection rapidly. Keep the area clean and dry, allow time without a diaper to let the area air dry. Applying barrier ointments can help prevent infections.
Mayhappen in any age group but usually not in infants less than 6 months. Looks raised, large red blotches and/or spots, can cover multiple areas or spots. Feels very itchy, stinging, burning sensation. Hives are most often caused due to an allergic reaction to food, medicine, environmental triggers, bites, or stings. Most of the time the cause is not identified, especially in an Urgent Care setting. It can be treated though. Over the counter antihistamine medications can help with itching. In severe cases, a rx medication might be needed. If a trigger is known, avoiding that food or substance is helpful.
RASHES THAT WILL NEED EVALUATION AND TREATMENT
It is a form of bacterial skin infection, looks swollen, redness, dimpled, painful and warm to touch. Treatment is antibiotics, in some severe cases IV medication can be needed.
Red, slightly raised bump. Very tender to touch- can have a boggy area in the middle of the rash, warm. Can give fever as well. Depending on the size and severity-patients can need minor surgical procedure and antibiotics.
There can be many different forms- from small red spots only to red bumps with blisters or hives and fever. Patient is to be evaluated in the Urgent care or primary doctor’s office.