BASICS OF RASHES

  • Childhood rashes are very common.
  • Most times it is caused by Virus.
  • The bacterial cause needs to be evaluated/ treated.
  • Glass test ( described ahead) helps to decide further action.
  • If the child has a rash and is clinically unwell( looks septic), then you need to see a medical professional.
  • Generally, children with viral rash are relatively well compared to bacterial causes. Once the fever is controlled, children with viral infections will spring back to being active.
  • Bacterial infections tend to cause the child to be Toxic /Septic and will not have periods of being well.
  • They continue to deteriorate until antibiotics are started.
This information is more for understanding rashes than diagnosing. (Don’t diagnose rash yourself. See a doctor if any doubts)

GLASS TEST

  • Take a clear glass( Example glass tumbler/ Glass slide) and press on the rash. If it fades, It is generally safe. If it stays the same then call your doctor immediately.
  • You can also do this test by widening the rash with your thumb and index finger( Stretch the skin to look for fading)
CHICKEN POX( VARICELLA)
  • Chickenpox is a viral illness.
  • Most children will experience it sometime in their life
  • Chickenpox immunity(resistance) is supposed to last for life.(until the body resistance weakens-like in old age/ stress/ steroid use)
  • There is a history of high fever, running nose, vomiting, loose stools prior to rash.
  • The rash very rapidly progresses( within hours)- starts as red, itchy spots that turn into fluid-filled blisters.
  • They quickly begin to crust over to form scabs, which eventually fall off.
FIRST AID
  • Control temperature with Paracetamol/ Ibuprofen
  • Can give anti-allergic medication ( Syrup Chlorphenamine/ cetirizine)
SEE A DOCTOR IF
  • Drowsy(unable to awaken/ change in behaviour)
  • Fast breathing/ uncontrolled fever
  • Worse skin infection/ discharge from rash

Babies < 7 days and preterm need hospitalisation

 PRICKLY HEAT RASH
  • Seen in young children/ babies.
  • Appears as red elevated vesicles(clear fluid filled boils).
  • Typically appears around neck region/ waist
  • These are harmless. The child is otherwise well. no fever/ no infection
TREATMENT
  • Keep the area well aerated
  • Moisturising creams/ Prickly heat powders help to contain ( Don’t use powders in babies)
SCABIES
  • Highly infectious. Generally in babies/ school children.
  • Caused by bugs( mites). They live in burrows in the lesion.
  • Highly itchy and generally many members of the same family are infected simultaneously
  • Appear as small red blotches and silver lines on the skin,
  • Common places are hands or soles of the feet( In between fingers).
  • In infants, appears as blisters on the soles of feet.
TREATMENT
  • The aim of treatment is to clear these bugs completely. Hence all family member is treated simultaneously
  • Babies < 1 year- see a doctor.
  • Permethrin 5% cream (Don’t use in pregnant contacts).
  • Apply to the whole body from the neck down and wash off after 8-14 hours.
  • Malathion 0.5% aqueous lotion.(wash after 12 hours).
  • Anti-allergic syrup to control itching
  • Severe infections may need to be retreated in 15 days.
  • Its very important to wash all garments, bed sheets in hot water.
MEASLES
  • Is a highly infectious viral illness
  • The infection usually clears in around 7-10 days.
  • Once you’ve had measles, your body builds up immunity (resistance) to the virus and it’s highly unlikely you’ll get it again.
SYMPTOMS
  • Measles is unlikely if immunised with MMR.
  • A runny nose, sneezing, cough
  • High fever, red eyes
  • Lethargy/ body ache
  • Following above symptom, after a day or 2 is red-rash will appear. that usually starts behind the ear and spreads down
TREATMENT
  • Give paracetamol/ibuprofen to control temperature
  • Drink plenty of water
  • Ask your doctor for vitamin A medication(It fastens recovery)
WHEN TO SEE YOUR DOCTOR
Every case of measles needs to be discussed with a doctor. It isn’t right to develop a disease even after vaccination, isn’t it?
TREATMENT
  • Give paracetamol/ibuprofen to control temperature
  • Drink plenty of water
  • Ask your doctor for vitamin A medication(It fastens recovery)

DANGER SIGNS

  • Fast breathing/ Drowsy
  • Uncontrolled temperature
PETECHIAE( Bleeding into skin)
  • Petechiae is an important sign to see your doctor.
  • Purple or red spots that don’t fade when put under pressure
  • Glass test is positive( the rash doesn’t fade/ it appears permanent)
  • Meningitis presents with petechiae, hence very child with this needs to be seen by your doctor immediately.
  • The various virus also causes petechiae, but they tend to be pinpoint and the child doesn’t appear septic/ unwell.
  • Certain bleeding conditions/ clotting conditions can present as petechiae.

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