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Should Your Child See a Doctor?

Rash – Widespread and Cause Unknown

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Definition

  • Rash over large areas or most of the body (widespread or generalized)
  • Occasionally just on hands, feet and buttocks - but both sides of body
  • Red or pink rash
  • Small spots, large spots or solid red skin

Causes 

  • Main cause: a 2 or 3 day rash occurring with a viral illness. Viral rashes usually have symmetrical pink spots on the trunk.

Return to School 

  • Most viral rashes are no longer contagious once the fever is gone.
  • For minor rashes, your child can return to child care or school after the FEVER is gone.
  • For major rashes, your child can return to child care or school after the RASH is gone or your doctor says it's safe to return with the rash.

When to Call Your Doctor for Rash - Widespread And Cause Unknown

Call 911 If…

 
  • Your child has purple or blood-colored rash with fever
  • Your child has sudden onset of rash (within 2 hours) and also has difficulty with breathing or swallowing
  • Your child is 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 rash WITHOUT fever
  • Bright red skin that peels off in sheets
  • Large blisters on skin
  • Bloody crusts on lips
  • Taking a prescription medication within the last 3 days
  • Fever
  • Menstruating and using tampons
 

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If

  • Widespread rash, but none of the symptoms described above (Reason: needs a diagnosis)
 

Home Care Advice for Widespread Rashes(Pending Talking with Your Doctor)

  1. For Non-Itchy Rashes: No treatment is necessary, except for heat rashes which respond to cool baths.
  2. For Itchy Rashes:
    • Wash the skin once with soap to remove irritants.
    • Then give your child cool baths without any soap 4 times per day for 10 minutes whenever the itch is uncomfortable (caution: avoid any chill).
    • Follow with calamine lotion or a baking soda solution (1 teaspoon in 4 ounces of water or 5 ml in 120 ml of water).
     
  3. Fever Medicine: For fever above 102°F (39°C), give acetaminophen (e.g. Tylenol) or ibuprofen.
  4. Contagiousness:
    • If your child has a fever, avoid contact with other children and especially pregnant women until a diagnosis is made.
    • Most viral rashes are contagious (especially if a fever is present).
    • Your child can return to child care or school after the rash is gone or your doctor says it's safe to return with the rash.
     
  5. Expected Course: Most viral rashes disappear within 48 hours.
  6. Call Your Doctor If:
    • Your child becomes worse
     

And remember, contact your doctor if your child develops any of the "When to Call Your Doctor" symptoms.


References

  1. Aber C, Connelly E, and Schachner L. Fever and rash in a child: when to worry? Pediatr Ann. 2007;36:30-38.
  2. American Academy of Pediatrics: Committee on Infectious Diseases. Rocky Mountain spotted fever. In Pickering L, ed. 2009 Red Book. 28th ed. Elk Grove Village, IL: 2009.
  3. American Academy of Pediatrics: Committee on Infectious Diseases. Meningococcal Infection. In Pickering L, ed. 2009 Red Book. 28th ed. Elk Grove Village, IL: 2009.
  4. Bialecki C, Feder HM Jr, Grant-Kels JM. The six classic childhood exanthems: A review and update. J Am Acad Dermatol. 1989;21:891-903.
  5. Buckingham SC, Marshal GS, Schutze GE, et al. Clinical and laboratory features, hospital course, and outcome of Rocky Mountain Spotted Fever in children. J Pediatr. 2007;150:180-184.
  6. Byer R, Bachur R. Clinical deterioration among patients with fever and erythroderma. Pediatrics. 2006;118(6):2450-2460.
  7. Cohen BA. Hot tub folliculitis. Contemp Pediatr. 2002;19(7):40.
  8. Darmstadt GL. Scarlet fever and its relatives. Contemp Pediatr. 1998;15(2):44-63.
  9. Dyer JA. Childhood viral exanthems. Pediatr Ann. 2007;36(1):21-29.
  10. Hall CB. Herpesvirus 6: New light on an old childhood exanthem. Contemp Pediatr. 1996;13(1): 45-57.
  11. Hartley AH. Pityriasis Rosea. Pediatr Rev. 1999;20:266-270.
  12. Herbert AA and Goller MM. Papulosquamous disorders in the pediatric patient. Contemp Pediatr. 1996;13(2):69-88.
  13. Melish ME. Kawasaki syndrome. Pediatr Rev. 1996;17:153-162.
  14. Milana C, Chandran M. What's new in Kawasaki Disease? Contemp Pediatr. 2006;23(7):40-47.
  15. Pollack S Staphylococcal scalded skin syndrome. Pediatr Rev. 1996;17:18.
  16. Slavin KA, Frieden IJ. Hand-foot-mouth disease. Arch Pediatr Adolesc Med. 1998;152: 505-506.
  17. Weston WL. What is erythema multiforme? Pediatr Ann. 1996; 25:106-109.

Disclaimer

This information is not intended to 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.

Author and Senior Reviewer: Barton D. Schmitt, M.D.

Last Reviewed: 8/1/2010

Last Revised: 9/18/2010 6:31:54 PM

Copyright 1994-2011 Barton D. Schmitt, M.D.

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