Ask Dr. Marla: My child gets a rash every time he's sick

By Dr. Marla Shapiro on May 24, 2012

Question:

Every time my child gets sick, he gets spots all over his chest and back. He’s had the chicken pox vaccine, but why does he get these spots?
 

Answer:

Rashes in children can be quite common and can be due to many different causes. Often the rash is due to a viral infection and is to be expected. Some rashes may have a pattern that is typical to the disease itself. While we immunize children against many common viral illnesses that cause rashes, such as measles, mumps, rubella and chicken pox, there are many other infections, both viral and bacterial that can cause a rash.

How can I tell if the rash is caused by a virus?

A viral rash is typically red and when it is pushed, it can turn white and make it seem that the rash is disappearing. Sometimes rashes can feel raised or the rash can appear as one large red area. The viral illnesses with rashes that are typical of the illness itself include chicken pox and measles. But for many other viral illnesses, the rash can be very non-specific.

Because you note the association of the rash with illness and not other times, it is likely due to the illness itself. However, in some kids with underlying atopic dermatitis or psoriasis, these can get worse during illnesses.

There are two common viral illnesses that we do not have immunization for:
  • Fifth disease or slapped cheek disease. In this case the rash looks as if the cheeks were slapped. Typically there is fever as well. The rash can then spread to other parts of the body.
  • Roseola. In this case there is usually a high fever for a few days without any other obvious symptoms. The fever then stops and while your child seems as if they are returning to their normal state of health, there is a rash that looks like red spots. It can start on the upper part of the body and then spread.

Can a bacterial infection also cause a rash?

Yes. Some can indicate an urgent situation such as meningitis. In this case the rash is flat and does not disappear when pressed. While most rashes are not concerning, it is always best to speak with your doctor to get a definitive diagnosis.

Originally published in ParentsCanada, May/June 2012

By Dr. Marla Shapiro| May 24, 2012

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