Rashes

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Fever in Summer Rashes

Rashes are a very common reason for doctors visits and disturb many parents. Rashes can be grouped into 6 categories:

Rashes with fever
Rashes after fever
Fifth's Disease
Hives
Rashes of Contact such as poison Ivy
Diaper Rashes

Rashes that occur with fever are the only rashes that are of immediate concern.

Be on particular lookout for maroon to purple color spots about the size of the opening of a ball point pen that may occur in the groin, in the area of the axilla, or the extremities. Whereas most rashes will blanch or temporarily fade, this rash does not because it is bleeding under the skin.

This is a cause to seek emergency medical treatment.

In contrast, rashes that occur after a fever has left are usually not a sign of serious disease even though they can be wide spread and alarming.

These rashes a typical of viral exanthems.

An example of one such rash is roseola which typically follows 3 to 5 days of fever. After the fever leaves the rash begins at the hairline and spreads downward over the trunk as a flat pink rash that blanches.

Other viral rashes can mimic roseola. These too are harmless although they may itch and it seems that infants are crabby for about 24 hours after the rash starts.

No treatment is required and the rash fades in 3 to 5 days.

Fifth Disease is so called because it is the 5th of 6th childhood exanthems. It is also called Erythema Infectiosum and is caused by a Parvo B19 virus.

Fifth's Disease comes in epidemics every 3 to 5 years and typically gives a "Slapped Cheek" appearance with a bright red rash over the face and a lacy flat rash over the inner thighs and arms. Often the rash is worse after a warm bath or activity. Sometimes the rash itches. Adults and older children who get this will sometimes have joint aches.

The incubation period is thought to be 4 to 14 days but may be as long as 21 days. Once the rash comes the child is no longer contagious.

Hives

Hives are whelps that have a variety of causes. Looking like mosquito bites they comes and go popping up in one place only to disappear and appear elsewhere.

Urticaria includes hives as well as flat circular rashes of various shapes that also comes and goes.

Causes of hives range from medicines, viral infections, foods, to idiopathic unknown.

Hives require no treatment except stopping any potentially offending medication. Oral antihistamines such as benadryl are sometimes helpful.

Diaper Rashes

As disposable diapers have become better at removing moisture from contacdt with a baby's skin, diaper rashes have cdhanged. When cloth diapers were common infant often got ammonical and irritant diaper rashes. Nowadays these are uncommon unless there is a great deal of diarrhea. For irritant rashes Aquaqhor and avoidance of wipes can be helpful.

Most rashes that fail to respond in 2 to 3 days to typical diaper rash medicines are monilial or yeast infections. These are found in young infants or can follow antibiotic use or infections. These can be treated with a number of different medications. Over the counter medicines to try are nystatin and lotrimin.

Several things can cause contact dermatitis ranging from poison ivy to soaps. These are treated with topical steroids such as hydrocortisone or something for itching such as Itch-X or Caladryl clear. Cool compresses and baths are helpful for temporary relief. Oral antihistamines are sometimes used. In cases that are particularly uncomfortable oral steroid are sometimes given.

Poison IVY can be helped with medicine, however, it is never absolutely necessary to treat. Contrary to popular opinion, once a child's skin is washed, poison ivy is not spread from contact with the rash even if it is weeping.

Eczema means dry itching skin. In addition to contact eczemas that may come from contact with metal, detergents, etc., some children have atopic eczema or a tendency towards rashy dry skin. For many children this is worse in the winter occurring as the humidity falls and both the air in the house and the child's skin dry out. This gives a clue to one aspect of treatment which is to keep the skin well lubricated. Thus after a bath, minimally pat your child so his skin is still wet then lubricating with the ointment of your choice can improve this. Topical steroids can be helpful but high potency steroids should be avoided in children, particularly on the face and in the groin. Newer non steroidal medicines are now available. Giving benadryl at bedtime can also be helpful.

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