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Skin Rashes in Children (cont.)

Bacterial Rashes

Many childhood diseases have viral or bacterial causes and include a rash of some type. As additional vaccines become available, these diseases become less of a threat to your child's long-term health. A rash of any kind should be taken seriously, however, and may require a trip to the doctor's office for evaluation. Examples of viral or bacterial rashes include several common childhood illnesses.

Impetigo

Impetigo is a superficial skin infection caused by streptococcal or staphylococcal bacteria. It is often found around the nose and mouth but can occur anywhere. The rash is more common in the warmer months. It can also occur as a secondary infection in skin that has been damaged, such as with insect bites, poison ivy, eczema, or abrasions.

  • Symptoms
    • Impetigo begins as small superficial blisters that rupture, leaving red, open patches of skin.
    • Often a honey-colored crust forms over this rash.
    • The rash may be quite itchy.
    • Impetigo is highly contagious. A child can spread the infection to other parts of the body by scratching himself or to other people by person to person (non respiratory) contact.
    • Impetigo is rarely a serious disease but is generally treated to cure the patient, reduce the risk of complications, and lessen the likelihood of transmission to others.
  • Treatment
    • This infection of the skin is easily treated with topical or oral antibiotics.
    • Your child usually is no longer contagious after one to two days of therapy. The rash begins to heal in three to five days.
    • If the rash does not show signs of healing by the third day of treatment, your child needs to be seen by a doctor.
    • If itching is intense, your child's doctor can recommend anti-itch medications.

Scarlet Fever (Scarlatina)

Scarlet fever is simply strep throat with a rash. The throat infection is caused by the bacteria group A Streptococcus pyogenes. It is most commonly seen in school-aged children in the winter and early spring, but it can occur in individuals of any age and in any season. It is very contagious, and the risk of transmission can be decreased with good hand washing. Strep infection may also occur around the anus or in the vaginal region.

The rash is not serious or contagious, but serious complications can occur from the underlying infection, strep infection. The most worrisome of these is rheumatic fever, a serious disease that can damage the heart valves and cause long-term heart disease.

  • Symptoms
    • The child's symptoms begin acutely with sore throat (which can be mild), moderate fever (101 F-103 F), headache, upset stomach, and swollen glands (lymph nodes) in the neck region.
    • After one to two days of these symptoms, the child develops a rash on the body that is red and has a sandpaper-like roughness. The classic medical description paints an accurate picture - "sunburn on skin with goose bumps." The rash usually spares the palms and soles.
    • The cheeks may look very flushed with a thin ring of normal skin around the mouth.
    • Symptoms of perianal or vaginal strep infection are those of moderate redness (without discharge) of the area associated with itching and often pain with passing stool or urine.
  • Treatment
    • Streptococcal sore throat can be treated with antibiotics.
    • Have your child seen by your doctor immediately if you suspect he or she has strep throat or scarlet fever.
    • Your child will require a full course of antibiotics, which should be finished even if your child is better before completion.
    • Your child may return to school or day care in 24 hours if the fever has resolved and he or she is feeling better.
Medically Reviewed by a Doctor on 4/8/2014

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