Springdale Mason Pediatrics

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 2000-2020 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.
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