Hilliard Pediatrics, Inc. - Dr. Tim Teller, MD
Rashes are very common in childhood. This handout is designed to help you with knowing what to do for rashes. A note: rashes are difficult to identify without seeing. A famous skin specialist for kids says he can tell you what the rash is over the phone if you can describe the shirt he is wearing at the time! Having said this, there are times when the look of a rash or the other symptoms going on can help us decide what is causing the rash. Whatever is the cause, many rashes fade within a short time
Rashes That Need Immediate Attention
There are some rashes that demand immediate attention. Like with many things, it is not just the rash but everything else going on that makes it an emergency.
- If a child has a fever plus severe headache, neck pain or stiffness, and/or is lethargic => we need to hear from immediately. We would be concerned that your child may have meningitis. Some of these children have a rash that is either many small, fine red dots that do not lighten when pushed on (petechiae) or larger deep red to purple flat areas (purpura). It is quite possible to have petechiae from bad coughing bouts or episodes of vomiting. If your child does not have neck pain or stiffness, is not lethargic, and does not have a severe headache, a fever and petechiae with a upper respiratory infection (“cold”) or vomiting (as with a “stomach flu”) can be watched. We want you to let us know right away, however, if purpura or petechiae and fever plus the headache, neck pain or stiffness, or lethargy are going on.
- If a child has many fine red dots that do not lighten when pushed on (petechiae) and/or large flat red to purple areas (purpura) and has more bruises than normal from bumping into things, bloody noses, and/or bleeding from the gums of the mouth, we are concerned that your child may have an illness called ITP (idiopathic thrombocytopenic purpura). This needs to be evaluated promptly. Please let us know right away if your child has these symptoms.