Rashes of Childhood

Type of Rash	Appearance	Associated Conditions
Maculopapular	Macules – flat erythematous areas of skin Papules – raised erythematous areas of skin *Both will blanch under pressure*	Measles Rubella (only macules) HHV6 / HHV7 Enterovirus Scarlet fever Kawasaki’s disease DRUGS!
Purpuric / petechial	*Non-blanching* red/purple coloursed spots. Test them with a glass	Meningococcal Henoch-Schonlein purpura Enterovirus Thrombocytopaenia
Vesicular	Raised, dome shaped lesions, <5mm diameter. Contain colourless fluid	Chickenpox Shingles Herpes Simplex Hand, foot and mouth
Pustular / bullous	Raised, dome shaped lesions, >5mm diameter. Contain colourless fluid or pus	Impetigo Scalded skin syndrome
Desquamation	Epidermal layer peels away. Most commonly found in the extremities.	After Scarlet fever Kawasaki’s disease After Measels

Rash	Age	Info	Treatment	Image
Mongolian Blue Spot	*Congenital*	Common in Asian and Black children. Clinically significant as it may be mistaken for bruising. Typically occurs on the lower back. Most disappear by age 5-6, and nearly all by puberty.	None. Present at birth and fades over time, although some adults may still have a visible rash
Erythema toxicum	2- 5 days	Very common – up to 50% of newborns, 2-5 days after birth. The *cause is unknown.* Appears a blotchy red patches on the skin, sometimes with papules and pustules	Usually resolves without treatment within a few days
Strawberry Naevus aka Strawberry Haemangioma	6-7 weeks old at presentation	Not present at birth, but develops during the first few weeks of life. A raised red lumpy spot, well demarcated. Can occur anywhere on the body, and grows for up to 18 months. After this time, will recede, and eventually disappear (usually by age 7). Can also occur in the trachea.	Usually none, but if around the eyes, or in the trachea may need to be removed. Can be done via laser or surgically, but they tend to bleed a lot! Can also try to reduce the size with topical steroids and propanolol.