RASHES, LOCALIZED AND CAUSE UNKNOWN

Symptom Definition

Rash on one part of the body (localized or clustered).
Red or pink rash.
Small spots, large spots or solid red.

Causes

Main cause: skin contact with some irritant.
Other common causes: 8 rashes that you may be able to recognize are listed below. If you suspect one of them, go there. If not, use this guideline.

Return to School

Children with localized rashes do not need to miss any day care or school.

Source: LMS Inc. -- Copyright 2000-2006. LMS, Inc. Used by Permission.

Diaper Rash Diaper Dermatitis in a Female Infant

Rash starts off with small pink and red spots; these spots gradually merge and the entire area under the diaper can become red appearing.
Trapped moisture under the diaper is the main cause of redness. Prolonged contact with urine or stool further irritates the skin.
Prevention and treatment of this rash are the same: change diapers frequently, keep the skin clean and dry.

Source: CDC PHIL -- From the CDC's Public Health Image Library (http://phil.cdc.gov), ID#4510, in the public domain.

Fifth Disease

There is redness and puffiness of both cheeks; this is the first sign of Fifth's Disease.

Fifth Disease

This otherwise healthy appearing child presented with bright red cheeks on both sides for 2 days ("slapped cheek" appearance).

Source: NZ DermNet -- Used by Permission. Copyright 2004 NZ DermNet.

Hand, Foot, And Mouth Disease

The photo demonstrates small flat blisters on the palms of both hands.
Hand, Foot and Mouth Disease is a harmless illness caused by Coxsackie virus.

Hand, Foot, And Mouth Disease

The photo demonstrates small red spots and a few small flat blisters on the bottom of the foot.
Hand, Foot and Mouth Disease is a harmless illness caused by Coxsackie virus.

Hand, Foot, And Mouth Disease

The photo demonstrates small flat blisters on the the palm of the hand.
Hand, Foot and Mouth Disease is a harmless illness caused by Coxsackie virus.

Menigococcemia Rash

This photo shows a petechial rash on the foot from meningoccemia.

Meningococcemia is a life-threatening illness, that progresses rapidly.
The photo shows a dark-reddish-purple spots on the top of the foot. These are referred to as petechiae.
Petechiae are small red or purple spots that do not disappear when pressure is applied to the skin. For example, if you press a glass down on the spots, they do not disappear. You can still see them through the glass.

Ringworm Rash on Arm

Notice that the area is round and pink. It has a raised rough scaly border. The ring slowly increases in size. It is usually slightly itchy.

Source: CDC PHIL -- From the CDC's Public Health Image Library (http://phil.cdc.gov), ID#2938, in the public domain. -- Content provider: Dr. Lucille K. Georg.

Ringworm

This patient presented with ringworm on the arm, or tinea corporis due to Trichophyton mentagrophytes.
The genus Trichophyton inhabits the soil, humans or animals, and is one of the leading causes of hair, skin and nail infections, or dermatophytosis in humans.

Erythema Migrans Rash

It is thought that Lyme Disease can be prevented if the tick is removed within 24 hours of attachement.
The majority of cases of Lyme disease start with a bull's eye rash ("erythema chronicum migrans") at the site of the tick bite. The rash can occur days to weeks (typically 7-10 days) after a tick bite.
Treatment with antibiotics is indicated if this rash appears.

Source: LDF -- Photo used by permission and courtesy of Lyme Disease Foundation, www.lyme.org.

See More Appropriate Topic for a Non-Itchy Rash If

See More Appropriate Topic for an Itchy Rash If

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WHEN TO CALL YOUR DOCTOR

Call 911 now (your child may need an ambulance) if:

Not moving or too weak to stand

Call your doctor now (night or day) if:

Your child looks or acts very sick.
Purple or blood-colored spots or dots that's not from injury or friction.
Bright red area or red streak (but not sunburn).
Rash area is very painful.
Age less than 1 month old and tiny water blisters (like chickenpox).

Call your doctor within 24 hours (between 9am and 4pm) if:

You think your child needs to be seen
Severe itching or fever is present
Looks like a boil, infected sore, pimples or other infected rash
Teenager with genital area rash
Lyme disease suspected (bull's eye rash, tick bite or exposure)

Call your doctor during weekday office hours if:

You have other questions or concerns
Blisters unexplained (EXCEPTION: Poison Ivy)
Pimples
Peeling fingers
Rash lasts for more than 7 days

Parent care at home if:

Mild localized rash and you don't think your child needs to be seen.

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HOME CARE ADVICE

Reassurance: New localized rashes are usually due to skin contact with an irritating substance.
Avoid the cause.

Try to find the cause.
Consider irritants like a plant (e.g., poison ivy), chemicals (e.g., solvents or insecticides), fiberglass, detergents, a new cosmetic, or new jewelry (e.g., nickel).
A pet may be the intermediary (e.g., with poison ivy or oak) or your child may react directly to pet saliva.

Avoid Soap: Wash the area once thoroughly with soap to remove any remaining irritants. Thereafter avoid soaps to this area. Cleanse the area when needed with warm water.
Local Cold: Apply a cold wet washcloth or soak in cold water for 20 minutes every 3 to 4 hours to reduce itching or pain.
Steroid Cream: If the itch is more than mild, apply 1% hydrocortisone cream (no prescription needed) every 2 hours until it feels better, then 4 times per day. (EXCEPTION: suspected ringworm)
Avoid Scratching: Encourage the child not to scratch. Cut the fingernails short.
Contagiousness: Children with localized rashes do not need to miss any day care or school.
Expected Course: Most of these rashes pass in 2 to 3 days.
Call Your Doctor If:

Rash spreads or becomes worse
Rash lasts over 1 week
Your child becomes worse

And remember, contact your doctor if your child becomes worse or develops any of the "Call Your Doctor" symptoms.

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REFERENCES

Carter S. Etiology and treatment of facial cellulitis in pediatric patients. Pediatr Infect Dis J. 1983;2:222.
Cohen BA. Warts and children: Can they be separated? Contemp Pediatr. 1997;14(2):128-149.
Darmstadt GL. A guide to abscesses in the skin. Contemp Pediatr. 1999;16(4):135-145.
Friedlander SF. Contact dermatitis. Pediatr Rev. 1998;19:166-171.
Honig PJ, Frieden IJ, Kim HJ, Yan AC. Streptococcal intertrigo: an underrecognized condition in children. Pediatrics. 2003; 112(6):1427-1429.
Weston WL and Bruckner A. Allergic contact dermatitis. Pediatr Clin North Am. 2000.

Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

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