Identifying Skin Rashes in Children

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A skin rash can be caused due to some allergic reaction, drug unsuitability or even a growing infection. Although, most rashes can go away with time and without treatment, some of them can be really harmful for your child’s health.

So, let’s learn to recognize the symptoms of these gruesome bacterial rashes and cure them immediately.

1. Impetigo is a superficial skin infection that occurs in the presence of streptococcal or staphylococcal bacteria. Mostly seen around the nose and mouth, it can occur anywhere on the skin. More prone to grow in the warmer months, it can also occur as a secondary infection in skin that is infected further due to insect bites, poison ivy, eczema, or abrasions.

Symptoms of Impetigo

(i)   Starts as small blisters that rupture eventually, leaving tiny red coloured, open patches of skin

(ii)  Dries out with a honey-colored crust

(iii) The rash may cause a lot of itching

(iv)  Contagious. Spreads to other parts of the body if scratched

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Treatment of Impetigo

(i)   Cured with simple prescriptions including topical/ oral antibiotics.

(ii)  The rash becomes non-contagious if the therapy is undertaken for two days at least.

(iii) The rash begins to heal in three to five days.

(iv)  If the rash is still fresh by the third day of treatment, see the doctor immediately. If itching is intense, ask for an anti-itch medicine from the child’s doctor.

2. Scarlet Fever (Scarlatina)

Caused by the bacteria group- A Streptococcus pyogenes; Scarlet fever is a strep throat or other strep infection with a characteristic rash. Commonly seen in school-aged children in the winter and early spring; it can also occur in people of any age and in any season. Strep infection may also occur around the anus or in the vaginal region.

It is very contagious, and the risk of transmission can be decreased with good hand washing.

The rash at the beginning doesn’t pass to another but serious complications can appear from the underlying strep infection. The most worrisome outcome of this kind of an infection is rheumatic fever, a serious disease that can damage the heart valves and cause long-term heart disease.

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Symptoms of Scarlet Fever

(i)   The child begins showing symptoms acutely with a sore throat, moderate fever (101 F-103 F), headache, upset stomach, and swollen glands (lymph nodes) in and around the neck area.

(ii)  After a day or two, a red rash appears on the child’s skin that has a sandpaper-like roughness. The classic medical description about this kind of a rash is explained as “sunburn on skin with goose bumps.”

(iii) The cheeks may look very flushed with a thin ring of normal skin around the mouth.

(iv)  Symptoms of perianal or vaginal strep infection are those of moderate redness (without discharge) of the area associated with itching and often pain with passing stool or urine.

Treatment of Scarlet Fever

(i)   Streptococcal sore throat as well as perianal or vaginal strep infections should be treated with antibiotics and should not be neglected.

(ii)  A proper course of antibiotics is a must, which should not be stopped in between even if the child is better before completion.

(iii) Do not send the child to school or outdoors before 24 hours at least, once the treatment is showing positive results.

(iv) Although there are vaccines for these viral skin infections now, we should still be cautious and aware of the symptoms

A. Chickenpox (Varicella)

A very contagious disease, Chickenpox is caused by a virus called varicella-zoster. Very uncomfortable for a child, generally last two weeks and can make the child very uncomfortable. Other than kids, chickenpox can be a serious illness in people with weak immune systems, those on chemotherapy for cancer, people consuming steroids, pregnant women, or those with HIV/AIDS. An effective vaccine is now available to children aged 1 year or older to prevent chickenpox. The symptoms of chickenpox generally appear 10-21 days after exposure.

Symptoms of Chickenpox

(a) Beginning with a fever, sore throat, and excessive tiredness among those who are struck with this disease; it follows with an appearance of an intensely itchy rash that typically begins on the head and torso and then spreads outward to the arms and legs. The total duration of the rash is seven to 10 days.

(b) The rash begins as an area of redness with a small, superficial blister in the center. It then ruptures in a day or two, forming a crusty scab over the rash that will fall off in two to three days. This entire evolution takes four to five days.

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Treatment of Chickenpox

Chickenpox will not respond to antibiotics. Paracetamol helps in bringing down the fever but in several cases, the doctor may give an antiviral drug to the infected child. Some homeopaths have also found out that sulphur boosts a child’s immune system. A medicated lotion or calamine lotion can also be prescribed to relieve the itchiness.

REMEMBER- Never give aspirin if the child is infected with Chickenpox as it can cause a condition called Reye’s syndrome, which can be life-threatening.

B. Measles (“Regular” or “Hard” Measles)

A paramyxovirus causes measles. Although, a vaccine is out for this disease too, people who are not fully vaccinated are prone to be getting attacked by measles in an older age.

Symptoms of Measles

(a) Starts with mild irritation. The disease gradually develops with nasal congestion and cough, eye redness without discharge, and moderate fever (102 F-103 F).

(b) On the third or fourth day, fever goes up (104 F-105 F) and the child will develop a purplish red rash on the face, along the hairline, and behind the ears first. It then spreads to the thighs and feet. After approximately a week, the rash fades in the same pattern as it developed.

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Treatment of Measles

The measles vaccine is part of the MMR (measles, mumps, and rubella) vaccine given at age 12-15 months and repeated at age 4-6 years.

C. Rubella (German Measles or “Three-Day Measles”)

Caused by rubivirus; Rubella is a milder disease than “regular” measles.

Symptoms of Rubella

(a) Rubella is spread by virus in nasal and oral secretions.

(b) The infected child will develop a pink or light red rash on the face that then spreads to the body. The rash does seem to itch to a mild degree. Other symptoms include low-grade temperature (100 F), headache, mild joint pains, conjunctivitis without discharge, and swollen lymph nodes in the neck and especially behind the ears. These symptoms increase in 3-4 days.

(c) If a pregnant mother develops rubella early in her pregnancy, it can be very dangerous for the unborn child. All women of childbearing age should have their immune status verified. Complications include congenital rubella syndrome. Congenital rubella syndrome occurs when intrauterine infection occurs during the first trimester. If not prevented; the development and functioning of the brain, heart, vision, hearing, and liver of the infant may suffer badly.

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Treatment of Rubella

Rubella is easily prevented with an effective vaccine (the MMR) generally administered at 12-15 months with a booster dose at 4-6 years of age.

D. Hand, foot and Mouth disease (HFMD)

HFMD is contagious and caused by different viruses. Infants and children below 5 years are more likely to get it but older children and adults can also get struck with this disease.

Symptoms of HFMD

(a) Begins with a fever, reduced appetite, sore throat, restlessness and tiredness.

(b) In a day or two, painful boils/ ulcer-like sores can develop in the mouth. A skin rash with flat red spots may also develop on the hands (palms) and the feet (soles). There may appear a rash on the knees, elbows, and buttocks, which may blister but won’t itch.

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Treatment of HFMD

There is no specific treatment for HFMD. Fever and pain can be managed with over-the-counter fever reducers and pain relievers, such as acetaminophen or ibuprofen. It is important for people with HFMD to drink enough fluids to prevent dehydration (loss of body fluids).

Some commonly found fungal infections are:

1. Ringworm 

It’s a red, scaly patch or a bump that is extremely itchy and gradually, begins looking like a ring or a series of rings with elevated, bumpy, scaly circles.

When this infection appears on the feet, it’s known as athlete’s foot. The patchy rash appears between the toes and at times, it may not look like rings at all but just red, scaly patches.

Symptoms of Ringworm

i)  Sores like a pimple before becoming patchy, flaky, or scaly.

ii) If appearing on the scalp, it may cause some hair to fall from the infected area out or break unevenly.

iii) If appearing on the nails, one can detect it if the nails become thick, white or yellowish, and brittle. Generally, it is more common during/ after puberty.

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Treatment of Ringworm

i)  Usually, a ringworm can be easily diagnosed based on how it looks, but sometimes a small sample of the infected skin can be taken.

ii) An anti-fungal medication is prescribed with a topical ointment or cream to be applied regularly.

2. Heat Rash (‘Prickly heat)

We all have faced this one. A heat rash is more like dots or tiny pimples all over a large area on the body. It mostly appears on the head, back and even the chest. A lot of irritation can be felt due to clothes and scratching can lead to further spreading of the rash.

Symptoms of Heat Rash

i.) Increased pain, swelling, redness, or warmth felt around the affected area. Red streaks growing from the infected area. Drainage of pus can happen, if overlooked. Swollen lymph nodes in the neck, armpit, or groin.

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ii.) Fever can begin with 100.4 °F (38 °C) or higher, or chills with no other known cause.

Treatment of Heat Rash

i.)  Don’t dress up the child in tight clothes or too many clothes. Keep the body temperature cool as much as possible.

ii.)  Let the skin air-dry instead of using towels.

iii.) Avoid ointments or other lotions, because they can irritate the skin. The doctor will prescribe a medicated talc for this infection.

There can be rashes because of an insect bite too.

Honey bee, wasp, yellow jacket, hornet, or fire ant stings are the insect stings that may stimulate an irritating rash. However, only normal sting reaction results when an insect bites and rare are the chances that an allergic reaction is experienced.

The most serious reaction to an insect sting is an allergic one that should not be neglected and given an immediate medical attention.

Most insect bites and stings cause itching and swelling that usually clears up within several hours.

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Treatment of insect bites generally

a.) Washing the affected area with soap and water

b.) Placing a cold compress (ice/ clean cloth dipped in cold water/ cold flannel) over the affected area to reduce swelling. Try and keep your child away from scratching the infected area.

c.) See the doctor if the redness and itching gets worse or doesn’t clear up after a few days.

d.) Use a spray or cream that contains local anaesthetic, antihistamine or mild hydrocortisone (1%) on the affected area to prevent itching and swelling

Image source: via Google Images

Note: Please know that the treatments can vary, depending upon the seriousness of the infection. It is advised to stay in touch with your child’s doctor constantly.

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