Rash Widespread - Cause Unknown

Definition

A pink rash that is all over the body (widespread)
Small or large pink spots
Cause of the rash is unknown

Call or Return If

Rash becomes purple or blood-colored
Rash starts to look like hives
Rash becomes very itchy
Fever lasts more than 3 days
Rash lasts more than 4 days
You think your child needs to be seen
Your child becomes worse

About This Topic

Causes

Most non-specific rashes are caused by viruses. A common one is the Coxsackie virus.
Viral rashes are more common with summer viruses.
Some viruses can be diagnosed by the pattern of the rash. A good example is Hand-Foot-and-Mouth disease. It starts with red spots and tiny blisters on the palms and soles.
Some viruses can be diagnosed by the pattern of the fever (Roseola). The rash starts 12 to 24 hours after the fever goes away. Most children get Roseola between 6 months and 3 years of age.
Hives is likely if the rash is bumpy and itchy. Most cases of hives are also caused by a virus. Hives can also be an allergic reaction.
Heat rash
Insect bites
Sunburn
Widespread rashes with fever need to be seen, if they have not been diagnosed. Reason: There are some serious infections that can cause these rashes.

Viral Rashes and Drug Rashes

Prescription medicines sometimes cause widespread rashes. Some are allergic, but most are not.
Non-prescription (OTC) medicines rarely cause any rashes.
Most rashes that occur while taking an OTC medicine are viral rashes.
Fever medicines (acetaminophen and ibuprofen) cause the most needless worry. Reason: Most viral rashes start with a fever. Hence, the child is taking a fever medicine when the rash starts. But the fever medicine had nothing to do with the rash.
Drug rashes can't be diagnosed over the phone.

Prevention of Spread to Others

Good hand washing can prevent spread of infection.

After Care Advice

Overview:

Most rashes with small pink spots all over are part of a viral illness. A fever makes this more likely.
Other symptoms such as diarrhea or a cold point to a viral rash.
These viral rashes are harmless and go away on their own.
Here is some care advice that should help.

For Non-Itchy Rashes:

For viral rashes, no treatment is needed or helpful.
If you suspect a heat rash, give a cool bath.

For Itchy Rashes:

Most viral rashes are not itchy. If your child's rash is itchy, here are some tips.
Cool Bath. For flare-ups of itching, give your child a cool bath. Do this for 10 minutes. Avoid all soaps. Reason: Soaps, especially bubble bath, make the skin dry and itchy. Option: Can add 2 ounces (60 ml) of baking soda per tub.
Moisturizing Cream. Use a moisturizing cream once or twice daily. Examples are Eucerin or Cetaphil creams. Apply the cream after the bath. Reason: Water-soaked skin feels less itchy.
Steroid Cream. For relief of severe itching, use 1% hydrocortisone cream on the most itchy areas. No prescription is needed. Do this 3 times per day.
Scratching. Encourage your child not to scratch. Cut the fingernails short. Reason: Prevent a skin infection from bacteria.

Other Symptoms:

Treat any other viral symptoms (such as diarrhea) in the usual way.

Fever:

For fevers above 102° F (39° C), give acetaminophen (such as Tylenol) or ibuprofen. Note: Lower fevers are important for fighting infections.
For ALL fevers: Keep your child well hydrated. Give lots of cold fluids.

What to Expect:

Most viral rashes go away in 2-3 days.

Return to School:

If your child has a fever, avoid contact with other children. Also try to avoid contact with pregnant women.
Most viral rashes cannot be spread to others once the fever is gone.
For minor rashes, your child can return after the FEVER is gone.
For major rashes, your child can return after the RASH is gone. If your doctor has given medical clearance to return, can go back sooner.

Author: Barton Schmitt MD, FAAP
Copyright 2000-2021 Schmitt Pediatric Guidelines LLC
Disclaimer: This health information is for educational purposes only. You the reader assume full responsibility for how you choose to use it.
Article 2564