Rash - Widespread And Cause Unkown

Symptoms

DEFINITION

  • Rash over large areas or most of the body (widespread or generalized)
  • Occasionally just on hands, feet and buttocks - but both sides of body
  • Red or pink rash
  • Small spots, large spots or solid red skin

Causes

  • Main cause: a 2 or 3 day rash occurring with a viral illness. Viral rashes usually have symmetrical pink spots on the trunk. 
  • Other common causes: 5 rashes that you may be able to recognize are listed below. If you suspect one of them, go to that topic. If not, use this topic.

Return to School

  • Most viral rashes are no longer contagious once the fever is gone.
  • For minor rashes, your child can return to child care or school after the FEVER is gone.
  • For major rashes, your child can return to child care or school after the RASH is gone or your doctor says it’s safe to return with the rash.

See More Appropriate Topic (instead of this one) If

Should I Call?

WHEN TO CALL YOUR DOCTOR

Call 911 Now (your child may need an ambulance) If
  • Purple or blood-colored rash with fever
  • Sudden onset of rash (within 2 hours) and also has difficulty with breathing or swallowing
  • 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 rash WITHOUT fever
  • Bright red skin that peels off in sheets
  • Large blisters on skin
  • Bloody crusts on lips
  • Taking a prescription medication within the last 3 days
  • Fever
  • Menstruating and using tampons
  • You think your child needs to be seen urgently

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If
  • Widespread rash, but none of the symptoms described above (Reason: needs a diagnosis)

Care at Home

HOME CARE ADVICE FOR WIDESPREAD RASHES (Until you talk with your Doctor)

  1. For Non-Itchy Rashes: No treatment is necessary, except for heat rashes which respond to cool baths.
  2. For Itchy Rashes:
    • Wash the skin once with soap to remove irritants.
    • Hydrocortisone Cream: For relief of itching, apply 1% hydrocortisone cream (no prescription needed) 3 times per day to the itchy areas.
    • Cool Bath: For flare-ups of itching, give your child a cool bath without soap for 10 minutes  (Caution: avoid any chill). Optional: Can add 2 ounces (60 ml) of baking soda per tub.
  3. Fever Medicine: For fever above 102°F (39°C), give acetaminophen (e.g. Tylenol) or ibuprofen.
  4. Contagiousness:
    • If your child has a fever, avoid contact with other children and especially pregnant women until a diagnosis is made.
    • Most viral rashes are contagious (especially if a fever is present).
    • Your child can return to child care or school after the rash is gone or your doctor says it's safe to return with the rash.
  5. Expected Course: Most viral rashes disappear within 48 hours.
  6. Call Your Doctor If:
    • Your child becomes worse

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

Photo Example

Chickenpox Rash

Chickenpox is an infectious disease caused by the varicella-zoster virus resulting in an itchy blister-like rash, tiredness and fever.

It appears first on the trunk and face, but can spread over the entire body causing between 250 and 500 itchy blisters.

Source: Wikimedia Commons

Permission is granted to copy, distribute and/or modify this document under the terms of the GNU Free Documentation License.

This is a public domain image file from Wikimedia Commons. Wikimedia is a freely licensed media repository.

Chickenpox on Abdomen

The Chickenpox rash can occur on all body surfaces.

The rash is no longer contagious when all of the spots are crusted over and no new spots are appearing. This usually takes 7 days from the first appearance of the rash.

Source: LMS Inc.

Copyright 2000-2012. Self Care Decisions, LLC. Used by Permission.

Measles Rash

This child with measles is showing the typical red blotchy rash on his buttocks and back during the 3rd day of the rash.

Measles is an acute, highly contagious viral disease. Symptoms include fever, conjunctivitis (red eyes), runny nose, cough, and spots on the inside cheeks.

A red blotchy rash appears around day 3 of the illness, first on the face, and then becoming generalized.

Source: CDC PHIL

From the CDC's Public Health Image Library (http://phil.cdc.gov), ID#4497, in the public domain.

Penicillin Rash on the Arm

This patient had a widespread rash from an allergy to penicillin. The picture shows the arm.

Source: CDC PHIL

From the CDC's Public Health Image Library (http://phil.cdc.gov), ID#1268, in the public domain.

Content Provider(s): CDC / Dr. Sellers.

Viral Rash

This is a simple viral rash in a healthy young boy. The rash was caused by the Echovirus.

Source: CDC PHIL

Public domain image. CDC Public Health Image Library. Dr. Heinz F. Eichenwald. ID#3171.

Content Providers: CDC / Dr. Heinz F. Eichenwald.

Rocky Mountain Spotted Fever
This child's right hand and wrist displays the characteristic spotted rash of Rocky Mountain spotted fever.

Rocky Mountain spotted fever is the most severe and most frequently reported rickettsial illness in the United States. The disease is caused by the bacteria Rickettsia rickettsii. The disease is spread by ticks.

Source: CDC PHIL

From the CDC's Public Health Image Library (http://phil.cdc.gov), ID#1962, in the public domain.

Scarlet Fever Rash

The photo shows the typical Scarlet Fever rash on the forearm.

The scarlet fever rash first appears as tiny red bumps on the chest and abdomen that may spread all over the body. Looking like a sunburn, it feels like a rough piece of sandpaper, and lasts about 2-5 days.

Scarlet fever is a disease caused by the same bacteria (Streptococcus) that causes strep throat. A person with Scarlet fever has a throat that is red and sore, usually a fever, usually swollen glands in the neck, and a Scarlet fever rash.

Source: CDC PHIL

From the CDC's Public Health Image Library (http://phil.cdc.gov), ID#5163, in the public domain.

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Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Author and Senior Reviewer: Barton D. Schmitt, M.D. Clinical content review provided by Senior Reviewer and Healthpoint Medical Network.

Last Review Date: 6/1/2011

Last Revised: 8/1/2011

Content Set: Pediatric HouseCalls Symptom Checker

Version Year: 2012

Copyright 1994-2012 Barton D. Schmitt, M.D.

Is Your Child Sick?

Pediatric HouseCalls Symptom Checker is a parent guide for treating your child at home, calling your child's doctor or seeking immediate medical attention. Developed by Dr. Barton Schmitt, MD, FAAP, a board-certified pediatrician on staff at Children's Hospital Colorado. Dr. Schmitt has developed other health tools for parents, including the 3rd edition of Your Child’s Health (available in bookstores) and KidsDoc, a new iPhone and Android app for parents (available online).

Are You Sick?

David A Thompson, MD is the author of Adult HouseCalls Symptom Checker. He is a board-certified emergency medicine physician at Northwestern Memorial Hospital in Chicago. He has a national reputation in telephone triage, decision support tools, medical information technology and quality improvement. Adult HouseCalls Symptom Checker is a decision support tool for adults that has been reviewed and approved by adult physicians.

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