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

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

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