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  • Six Things You Should Know about Rashes

    child rashes.shutterstock_123958123Chances are that your child will develop at least one mysterious bump, welt or break-out in his or her childhood. While common, rashes may not be always benign. It’s a good idea to ask your child’s pediatrician to look at a rash and determine whether treatment (or just observation) is necessary.

    Usually, nothing is better than seeing the rash up close and in person; however, I can get clues over the phone to help me determine the possible cause and significance of a rash. Below, I’ve listed 6 questions I ask about a rash, which I hope can help you be better prepared when you call the doctor’s office.

    1.  Is there a fever?

    Fevers that accompany rashes may indicate an infection. The most common causes of rashes associated with fevers are viral infections. Viral illnesses such as Hand-Foot-Mouth disease or Fifth disease have a characteristic appearance and usually do not require any specific treatment (besides fever reducers as needed). Bacterial infections, such as cellulitis or strep throat, are less common but generally require some form of treatment, such as antibiotics.

    2.  Is the rash only on one area or in multiple places?

    Localized rashes are more consistent with direct irritants like diaper rash or contact dermatitis from poison ivy. A head-to-toe rash is more likely to occur from a systemic exposure like a virus or an allergic reaction to foods or oral medications.

    3.  Is it itchy, painful or “just there”? 

    For rashes without symptoms like itchiness or pain, my recommendation is usually to leave them alone. I discourage parents from putting lotions or other topical forms of treatment on them.

    An asymptomatic, all-over rash can follow a viral infection. For example, roseola is a red rash that shows up after a fever is gone. While generalized and impressive-looking, roseola is not contagious or a cause of concern once the rash appears.

    An example of a symptomatic, itchy rash is eczema or atopic dermatitis. Eczema looks like red, blotchy, scaly patches on the cheeks, neck, crook of the elbows and back of the knees.

    An example of a local, “just-there” rash is ringworm. This rash presents as round lesions with a raised, red border and a lighter, scaly center.

    4.  If it’s a red rash, is it “blanchable”?

    “Blanchable” means “turns white when pressing on it.” If you push on a red rash and the skin turns lighter momentarily, then it’s blanchable. This feature distinguishes a rash from a bruise because a bruise will not blanch. Non-blanchable rashes can be associated with bleeding underneath the skin either from injury or a clotting deficiency and can be more serious.

    5.  Are the eyes, mouth or joints also involved?

    The rash might be a clue to an issue beyond the skin, such as an inflammatory or allergic condition. I always ask if the white part of the eyes is red or if the inside of the mouth has swelling, blisters or bumps.

    6.  Is the rash new or has it been there for a while?

    If it started a few days ago, it’s acute. Chronic rashes have been there or have come and gone over some time frame. Chronic rashes may have evolved – by scratching, treatment or other means. In that case, I would want to know how it looked in the very beginning and how its appearance has changed over time.