Contageous Viral Rashes

You are waiting in your car, the bell rings and your little one comes running over to tell you all about the school day.  But wait, what has happened to her face?  Is she going to be okay?

The most common causes of contagious viral rashes in children are as follows:

Erythema Infectiosum

Erythema Infectiosum (aka Fifth Disease or Slapped Cheek Disease) is caused by the Parvovirus B19.  Fever is often low-grade or absent.  This rash begins with bright red cheeks (looks as though your child was “slapped” across the cheek).  1-2 days later a red, itchy rash (which can be made of raised bumps or flat spots) appears on the arms then spreads to the torso and finally reaches the legs.  The virus is spread thru respiratory droplets and is generally considered self-limited with resolution in 10-14 days.  However, if your child has high fevers, appears very sick, or has a family history of hemolytic anemia including sickle cell disease then you should see your Pediatrician immediately.

Chicken Pox

Chicken pox is caused by the Varicella-zoster virus.  Fever commonly begins 1 day before itchy lesions develop.  Each lesion begins as a bump that turns into a blister. When the blister pops a crust is left.   After the first couple of days, you should see bumps, blisters and crusts all at the same time.  If you suspect chicken pox, mark the bumps and in 24 hours recheck to see if blisters have formed.  Because chicken pox is very itchy, we recommend over the counter antihistamine like Benadryl and trimming your child’s fingernails to prevent secondary bacterial infection of the lesions.  If your child has high fevers, a weakened immune system or the lesions begin to look infected then you should consult your Pediatrician.

Hand-Foot-and-Mouth

Hand-foot-and-mouth disease is caused by Coxsackie A virus.  The rash is preceded 2-3 days by a fever.  Ulcers and blisters are seen in the mouth and throat, blisters appear on the palms and soles and sometimes a flat or bumpy rash may been seen on the buttocks.  Your child may not want to eat or drink due to the oral ulcers causing pain.  A common complication of this virus is dehydration.  Give your child cold liquids (Pedialyte popsicles) and avoid any acidic foods (oranges, lemons) which may cause a burning sensation when in contact with the oral ulcers.  Consult your Pediatrician if fever persists past 5 days, your child cannot eat or drink anything, or your child appears very ill.

Roseola Infantum

Roseola Infantum is  caused by HHV-6 (human herpes virus -6), is one of the most common causes of fever in children aged 3 months to 3 years.  Very high fevers (may be greater than 103 F) without other symptoms for approximately 3-4 days are characteristic.  As the fever breaks, a pinkish rash of flat or bumpy lesions appear on the trunk and then spreads to the face and upper and lower limbs.  The rash usually disappears within 1-2 days after onset.  The virus is self-limited but due to the associated high fevers, family history of febrile seizures, and child appears very sick,  you should consult your Pediatrician.

Molluscum Contagiosum

Molluscum contagiosum is caused by the poxvirus.  Fever is usually absent.  The lesions are firm, flesh colored dome shaped bumps that characteristically have an indented center known as a central umbilication.  The virus is spread by direct contact with other children who have viral lesions.   This is a self-limited condition which tends to resolve after a few months.  Treatment of the lesions such as cryotherapy (i.e. freezing) can be done for cosmetic purposes.

It should be noted that anytime your child has a rash that looks like dots of red ink (petechiae) or larger dots of purple/dark red ink (purpura) this could be an emergency.  When you press on these “dots” the color will remain (i.e, no blanching occurs)  and because these lesions represent broken blood vessels they are deeper in the skin you will not be able to feel them.  Please contact a doctor immediately.

Dr. Teresita Melocoton M.D.,

Kasie Kudrewicz OMS IV

Christine Melocoton