Rash or Redness - Localized And Cause Unknown

Symptoms

DEFINITION

• Rash on one small part of the body (localized or clustered)
• Red or pink rash
• Small spots, large spots or solid red
• Includes localized areas of redness or skin irritation

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Causes

• Main cause: skin contact with some irritant.
• Other common causes: 7 rashes that you may be able to recognize are listed below. If you suspect one of them, go there. If not, use this guideline.

Return to School

• Children with localized rashes do not need to miss any day care or school.

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See More Appropriate Topic (instead of this one) If

For an itchy rash:

• ATHLETE'S FOOT
• INSECT BITE
• POISON IVY
• RINGWORM

For a non-itchy rash:

• NEWBORN RASHES
• DIAPER RASH
• IMPETIGO (Infected Sores)

Should I Call?

WHEN TO CALL YOUR DOCTOR

Call 911 Now (your child may need an ambulance) If

• Not moving or too weak to stand

Call Your Doctor Now (night or day) If

• Your child looks or acts very sick
• Purple or blood-colored spots or dots that's not from injury or friction
• Bright red area or red streak (but not sunburn)
• Rash area is very painful
• Age under 1 month old and tiny water blisters (like chickenpox)

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If

• You think your child needs to be seen
• Severe itching or fever is present
• Looks like a boil, infected sore or other infected rash
• Teenager with genital area rash
• Lyme disease suspected (bull's eye rash, tick bite or exposure)

Call Your Doctor During Weekday Office Hours If

• You have other questions or concerns
• Blisters unexplained (EXCEPTION: Poison Ivy)
• Pimples (Apply antibiotic ointment until seen)
• Peeling fingers
• Rash lasts longer than 7 days

Parent Care at Home If

• Mild localized rash and you don't think your child needs to be seen

Care at Home

HOME CARE ADVICE FOR LOCALIZED RASHES

1. Reassurance: New localized rashes are usually due to skin contact with an irritating substance.
2. Avoid the Cause:
   • Try to find the cause.
   • Consider irritants like a plant (e.g., poison ivy), chemicals (e.g., solvents or insecticides), fiberglass, detergents, a new cosmetic, or new jewelry (e.g., nickel).
   • A pet may be the intermediary (e.g., with poison ivy or oak) or your child may react directly to pet saliva.
3. Avoid Soap: Wash the area once thoroughly with soap to remove any remaining irritants. Thereafter avoid soaps to this area. Cleanse the area when needed with warm water.
4. Local Cold: Apply a cold wet washcloth or soak in cold water for 20 minutes every 3 to 4 hours to reduce itching or pain.
5. Steroid Cream: If the itch is more than mild, apply 1% hydrocortisone cream (no prescription needed) 4 times per day. (EXCEPTION: suspected ringworm)
6. Avoid Scratching: Encourage your child not to scratch. Cut the fingernails short.
7. Contagiousness: Children with localized rashes do not need to miss any day care or school.
8. Expected Course: Most of these rashes pass in 2 to 3 days.
9. Call Your Doctor If:
   • Rash spreads or becomes worse
   • Rash lasts over 1 week
   • Your child becomes worse

And remember, contact your doctor if your child develops any of the "Call Your Doctor" symptoms.

Photo Example

Impetigo of Left Cheek

This photograph shows the typical appearance of impetigo. Impetigo is Often covered by a soft, yellow-brown scab or crust.

Diaper Rash

This photo shows a red diaper rash in the area under the diaper. Skin has become shiny.

Any diaper rash that lasts longer than a couple days can become secondarily infected with Candida (yeast). Note the red spots ("satellite lesions") outside the main area of redness.

If a yeast infection is suspected, Lotrimin cream (over-the-counter) should be applied 4 times daily.

Fifth Disease

There is redness and puffiness of both cheeks; this is the first sign of Fifth's Disease.

Ringworm Rash on Arm

Notice that the area is round and pink. It has a raised rough scaly border. The ring slowly increases in size. It is usually slightly itchy.