Rocky Mountain Spotted Fever: Another Illness from Ticks

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Rocky Mountain spotted fever is a bacterial infection first discovered in the western mountains of the United States. That’s how the disease got its name, but it occurs throughout the country–especially in mid-Atlantic and southern states.

Who is at risk?

The disease most often affects children and teens younger than 15 years old. Those who spend time outdoors or who have pets that may carry infected ticks, are at higher risk. Most cases of Rocky Mountain spotted fever happen between April and September, when ticks are most active, or whenever the weather is warm.

How does Rocky Mountain spotted fever spread?

Children usually get Rocky Mountain spotted fever from the bite of ticks that are infected with bacteria called Rickettsia rickettsii. Ticks that most commonly spread this bacteria include the American dog tick, Rocky Mountain wood tick and the brown dog tick.

Signs and symptoms:

Symptoms of Rocky Mountain spotted fever usually appear about 1 week after the tick bite, but it can range from 2 days to 2 weeks.

• Flu-like symptoms. Children infected with RMSF first have symptoms common to many other infectious diseases, including flu-like symptoms such as fever, muscle pain, severe headaches, vomiting, nausea, and loss of appetite.

• Rash. In addition, a rash usually develops, by the sixth day of the illness. This rash tends to appear first on a child’s wrists and ankles, but within hours it can spread to the torso. It also may spread to the palms of the hands and soles of the feet. Often, it starts out as flat red splotches or pinpoint dots but may change and become bumpy or purplish.

• Other symptoms. Other symptoms can include joint pain, stomach pain, and diarrhea. In severe cases, blood pressure can drop and cause the child to act confused. As the infection spreads, many organs, including the brain, can be affected.

When to call your pediatrician:

If your child has been exposed to ticks has been bitten by a tick and develops any of these symptoms, contact your pediatrician right away. The doctor will examine your child and run tests to confirm the diagnosis of Rocky Mountain spotted fever.

How is Rocky Mountain spotted fever treated?

If your pediatrician suspects your child has Rocky Mountain spotted fever, the doctor will prescribe antibiotic medicine right away. Treatment with this medication usually continues for 7 to 10 days or until the child’s fever has been gone for at least 3 days. Be sure your child takes the medicine for the whole time prescribed to make sure the infection is fully treated.

What is the prognosis?

With early treatment, nearly all children recover completely. In rare cases, Rocky Mountain spotted fever can make a child very sick and even become life-threatening. If left untreated, there can be risk of damage to blood vessels, nerves, and organs such as the heart, lungs and kidneys. Other possible complications can include hearing or vision loss, and gangrene in the fingers and toes that in severe cases can lead to amputation.

Prevention:

• Avoid contact. The best way to prevent Rocky Mountain spotted fever is to avoid direct contact with places ticks prefer, such as wooded and brushy areas with tall grass and leaf litter. Stay in cleared spaces and walk on sidewalks and near the center of trails. Have your child wear a long-sleeved shirt, pants, and hat, ideally in lighter colors that make ticks easier to spot. Avoid wearing sandals in tick-infested areas.

• Repellents. Products containing Environmental Protection Agency-registered insect repellents can be used on skin, but look for family-friendly concentrations and always follow directions. DEET, in concentrations of no more than 30% for children, currently is considered the best defense against ticks. Other repellents that may be effective include picaridin, soy oil, and oil of lemon eucalyptus (although oil of lemon eucalyptus should not be used on children under age 3). Don’t use any insect repellents on babies younger than 2 months old.

• Wash up. Wash the insect repellent off with soap and water when your child comes inside. Taking a bath or shower can also help remove loose ticks, which can take 4 to 6 hours to firmly attach to skin.

• Tick checks. Regularly inspect your child’s clothes and body for ticks, including the scalp and hair. Don’t forget to check your pets too. Ticks can be brought in to the house on a dog’s fur. After coming indoors, check for ticks on your child’s skin—they often hide behind the ears or along the hairline. If you think your child came in contact with ticks, check every day. If you were in an area known to have ticks, check twice a day until you are sure no ticks attached.

• Removing ticks. If you find a tick on your child’s skin, the sooner it comes off the less likely it will spread infection it may carry. But it’s important to remove it carefully. See How to Remove a Tick for details and instructions.

Remember…

Rocky Mountain spotted fever is relatively rare but can be serious if not treated early. Especially if you live in a tick-infested area, take steps to prevent it, know the symptoms and call your pediatrician promptly with any concerns.  

Additional Information:

• Choosing an Insect Repellent for Your Child

• Rocky Mountain Spotted Fever (Centers for Disease Control and Prevention)

• Rocky Mountain Spotted Fever (National Institute of Allergy and Infectious Diseases) 

Last Updated

7/31/2018

Source

Section on Infectious Diseases (Copyright © 2018 American Academy of Pediatrics)

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Skin rashes in children – Mayo Clinic

About this Symptom Checker

Skin rashes in children

Find possible causes of skin rashes based on specific factors. Check one or more factors on this page that apply to your symptom.

Rash best described as

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  Blisters




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  Itchy




• 
  Lacy and slightly raised




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  Oozing sores that become crusty




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  Pus-filled, crusty swellings




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  Raised, red welts

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  Red or discolored blotches




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  Red or discolored bumps




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  Red or discolored skin




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  Ring shaped




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  Scaly or flaky




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  Thick and leathery

Affects

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  A small site and then spreads




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  Buttocks




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  Diaper area




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  Face or neck




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  Folds of skin

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  Genital area




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  Hands or feet




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  Scalp




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  Trunk

Preceded by

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  Eating certain foods




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  Exposure to allergen or irritant




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  Exposure to irritating plants

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  Prolonged exposure to heat




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  Tick bite or possible exposure to ticks

Accompanied by

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  Brittle hair and hair loss




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  Dandruff




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  Diarrhea




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  Difficulty breathing




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  Fever




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  Headache




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  Joint pain




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  Loss of appetite

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  Mouth or tongue sores




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  Muscle aches or pains




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  Muscle weakness




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  Nausea or vomiting




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  Sore throat




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  Swelling of lips, face or tongue




• 
  Tender or painful scalp

1. Walls RM, et al. , eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, Pa.: Elsevier; 2018. https://www.clinicalkey.com. Accessed Oct. 30, 2017.
2. Palmer J, et al. Abdominal pain mimics. Emergency Medicine Clinics of North America. 2016;34:409.
3. UpToDate. https://www.uptodate.com/contents/search. Accessed Oct. 30, 2017.
4. Zeiter D. Abdominal pain in children. Pediatric Clinics of North America. 2017;64:525.
5. Palmer J, et al. Abdominal pain mimics. Emergency Medicine Clinics of North America. 2016;34:409.
6. Feldman M, et al. Sleisenger and Fordtran’s Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 10th ed. Philadelphia, Pa.: Saunders Elsevier; 2016. https://www.clinicalkey.com. Accessed Oct. 30, 2017.
7. Merck Manual Professional Version. https://www.merckmanuals.com/professional. Accessed Oct. 30, 2017.
8. AskMayoExpert. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2017.
9. Kliegman RM, et al. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, Pa.: Elsevier; 2016. https://www.clinicalkey.com. Accessed Nov. 2, 2017.
10. Zitelli BJ, et al., eds. Zitelli and Davis’ Atlas of Pediatric Physical Diagnosis. Philadelphia, Pa.: Elsevier; 2017. https://www.clinicalkey.com. Accessed Nov. 11, 2017.
11. Ferri FF. Ferri’s Clinical Advisor 2018. Philadelphia, Pa.: Elsevier; 2018. https://www.clinicalkey.com. Accessed Nov. 11, 2017.
12. Muncie HL, et al. Dizziness: Approach to evaluation and management. American Family Physician. 2017;95:154.
13. American College of Emergency Physicians. https://www.acep.org. Accessed Nov. 11, 2017.
14. U.S. Food and Drug Administration. http://www.fda.gov. Accessed Nov. 11, 2017.
15. Schmitt BD. Fever. In: Pediatric Telephone Protocols: Office Version 15th ed. Elk Grove Village, Ill.: American Academy of Pediatrics; 2015.
16. Mannenbach MS (expert opinion). Mayo Clinic, Rochester, Minn. June 14, 2017.
17. Goyal DG (expert opinion). Mayo Clinic, Rochester, Minn. June 14, 2017.
18. Hoecker JL (expert opinion). Mayo Clinic, Rochester, Minn. Aug. 28, 2017.
19. American Academy of Orthopaedic Surgeons. https://orthoinfo.aaos.org. Accessed Nov. 20, 2017.
20. Petty RE, et al., eds. Textbook of Pediatric Rheumatology. 7th ed. Philadelphia, Pa.: Elsevier; 2016. https://www.clinicalkey.com. Accessed Nov. 20, 2017.
21. Elsevier Point of Care. https://www.clinicalkey.com.  Accessed Nov. 20, 2017.
22. Kasper DL, et al., eds. Harrison’s Principles of Internal Medicine. 19th ed. New York, N.Y.: McGraw-Hill Education; 2015. http://accessmedicine.mhmedical.com. Accessed Nov. 20, 2017.
23. Wein AJ, et al., eds. Campbell-Walsh Urology. 11th ed. Philadelphia, Pa.: Elsevier; 2016. https://www.clinicalkey.com.. Accessed Dec. 2, 2017.
24. National Eye Institute. https://nei.nih.gov. Accessed Dec. 5, 2017.
25. Wilkinson JM (expert opinion). Mayo Clinic, Rochester, Minn. Nov. 8, 2017.

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Rashes in newborns | clinic blog Nashe Vremya

Pediatrician Lesiva Lika Igorevna talks about rashes in newborns.

The rash is localized on the face, head, in the oral and nasal cavities, as well as any part of the body. When combing, abrasions and erosion occur, a secondary infection may join.

A rash in a baby does not appear on its own, most often it is a sign of pathological processes in the body, although sometimes it is also a consequence of physiological conditions. Usually accompanied by additional symptoms – fever, sleep disturbance and appetite, joint and muscle pain, nausea, vomiting, weakness.

The rash may look different. First, primary elements are formed:

• pustules – small vesicles with purulent contents
• papules – raised firm nodules
• bullae blisters raised above the skin
• vesicles – small vesicles up to 5 mm containing exudate
• maculae – flat red spots
• plaques vesicles fused together
• petechiae – subcutaneous hemorrhages caused by capillary injury
• hemorrhages – subcutaneous hemorrhages caused by high permeability of vessel walls

After a while, secondary elements may form on the affected areas:

• hyperpigmentation or depigmentation skin discoloration
• desquamation – scaling of dying epidermis
• erosions – superficial lesions resulting from opening of a vesicle or pustule
• abrasions – violations of the integrity of the skin when scratching
• crusts – formations in place of burst pustules and vesicles
• lichenification – indurations of the skin with enhancement of its pattern

Most rashes are harmless and go away either on their own or with minor interventions. A baby is born with thin and sensitive skin, which tends to react sharply to any stimuli. Because of this, acne, peeling, redness appear. Despite the fact that usually skin manifestations are physiological and disappear on their own, some of them still require a mandatory examination and follow-up by a doctor.

Reasons for the appearance of

The causes of skin changes and lesions are physiological conditions, various diseases, allergic reactions and physical irritants.

Physiological states

At birth, the baby is covered with primordial lubrication, which protects the skin from pathogenic microorganisms. In the hospital, it is not completely removed so that the skin adapts to the environment. But later, external conditions begin to act on it, causing various reactions that pass over time and are not dangerous for the baby.

A few minutes after childbirth, the color of the skin changes – it becomes bright pink or reddish. This is due to the fact that the air pressure is lower than the pressure of the aquatic environment in which the newborn has been for a long time, blood begins to flow to the skin, changing its color. When the vessels return to normal, it will become the usual pink color. This takes about 2 weeks, premature babies a little more – up to 3 weeks.

At first, the baby’s skin may look like marble due to pink-purple spots. This is how the vessels react to cold, so marbling is usually noticeable when dressing or swaddling until the child is protected by clothes. If the marble spots are uniform and disappear when the baby is warmed, then there is no cause for concern. However, if something worries you, it is better to consult a doctor for advice so as not to miss heart or lung diseases, when marbling is a symptom of oxygen starvation.

On days 2-3, the baby’s skin begins to peel off due to the transition to a dry environment after the womb. The degree of peeling is different, in post-term children it is more pronounced. It goes away in a few days. If cracks occur during peeling, you need to use special tools – emollients. However, if the skin bursts and is very desquamated, you need to see a doctor to exclude ichthyosis, hyperkeratosis and other pathologies.

Babies can develop seborrheic dermatitis, which develops in places with a strong production of sebum. Appears as yellow scales on the head and behind the ears, less often in the axillary and inguinal folds. The second name for seborrheic dermatitis is “milk crusts”. Usually pass without treatment, do not cause itching and do not cause discomfort, although it does not look aesthetically pleasing. To speed up the healing process, you can use baby oil and comb out the scales with a soft baby comb. Sometimes antifungal and anti-inflammatory creams may be needed.

For physiological reasons, various rashes can occur – toxic erythema, neonatal acne, milia. This is normal, because the delicate skin of the baby adapts to new living conditions. A rash in a baby appears due to an increased content of hormones, activation of the sebaceous glands and blockage of the follicles.

Physical influences (overheating, cold, friction)

Baby’s skin is sensitive not only to the natural environment, but also to various mechanical influences and irritants. For example, overheating can cause prickly heat, contact with saliva can cause contact dermatitis, and a diaper can cause diaper dermatitis.

Infections

Infections that can cause rashes are viral, bacterial, or fungal. In this case, other symptoms are usually present – fever, intoxication, pain. See a doctor as soon as possible if the baby refuses to eat, the rash is accompanied by high fever, pus, severe swelling or redness of the skin. Hemorrhages in the form of red-blue blots, which do not disappear when pressed (test with a glass), require special attention.

Allergy

A rash in newborns can also appear upon contact with an allergen. Allergy can be food, contact, drug, cold, etc. Its symptoms are manifested by rashes, itching, urticaria, Quincke’s edema, runny nose, cough, bronchospasm and intestinal disorders (diarrhea, constipation, flatulence, colic). Anaphylaxis is life-threatening and requires an immediate emergency call.

Also, a rash in newborns is caused by autoimmune diseases, vascular and other pathologies of the body, but this happens extremely rarely.

Types of rashes

Types of rash in newborns depend on its cause and are divided into physiological and pathological , and the latter – into infectious, allergic and mechanical .

Physiological

Neonatal acne (neonatal pustulosis)

In the 3rd week of life, 20% of newborns may develop teenage acne. They occur under the influence of hormones and look like pustules with a red border. The rash on the body of the baby is usually localized on the face, sometimes spreads to the scalp, less often to the collar zone. It is not dangerous and goes away on its own in 1-3 months.

With neonatal acne, the skin needs to be properly cleansed and moisturized, and may sometimes require the use of medicated creams. It is absolutely impossible to squeeze out pimples and cauterize with alcohol-containing solutions. If the rash in the baby is abundant and leads to secondary infection, you should definitely see a doctor. Acne can drag on for a month or more, then it is considered infantile. If more than six months do not pass, the risk of developing acne in adolescence increases.

Milia

50% of babies develop small yellow or white nodules 1-2 mm in size, called milia or milia. These are cysts of the sebaceous glands that do not require removal. They spread to the face, head, chest and disappear in about a month.

Toxic erythema

This is a benign rash in a newborn child, resulting from the influence of the external environment on delicate skin. Develops by 2-3 days of life in 70% of babies in the form of small red rashes on the face, limbs, trunk. First, small dots appear, which later merge into spots with a 1-2 mm tubercle in the center. Toxic erythema is not dangerous and disappears within a week, sometimes 2-3 weeks. If something worries you, it is better to consult a doctor to rule out infections.

Pathological

Viral eruptions

Chickenpox

It starts with a few blisters and spreads throughout the body, including the scalp and mucous membranes. First, red spots appear, and then turn into bubbles. Then they burst and form crusts that cause itching and bother the baby. The rashes last 5-10 days.

Measles

A highly contagious disease characterized by a small raspberry-red rash that first appears in the mouth, then spreads to the whole body. Affected skin becomes rough, later scaly patches remain for 1–2 weeks. Develops against the background of high temperature.

Rubella

Small pink-red spots appear on the head, and then all over the body, which last 2-4 days, and then disappear. Other symptoms are sore throat, nasal congestion, high fever.

Herpes

A rash in newborns occurs in the form of blisters on the lips and in the oral cavity, which disappears in 1-2 weeks.

Infectious mononucleosis

With infectious mononucleosis, densely spaced pink spots of about 10–15 mm appear. Other symptoms are high fever, swollen lymph nodes, sore throat.

Roseola

First, the temperature rises, after its normalization, small light pink dots appear. It goes away on its own and does not require treatment.

Coxsackie syndrome

Bubble rashes appear on the palms, feet and in the oral cavity. Additional symptoms are fever, vomiting.

Erythema infectiosum (fifth disease)

This is a common viral infection among newborns, which is manifested by a red rash on the cheeks and is accompanied by fever. It resolves on its own in a few days and does not require treatment.

Molluscum contagiosum

Appears as a cluster of white-pink bubbles with curdled contents inside. It is usually localized on the face, neck, eyelids, trunk and extremities.

Bacterial rashes

Scarlet fever

With scarlet fever, numerous red dots appear in the folds of the skin, on the abdomen and on the sides of the body, accompanied by itching and flaking. A distinctive feature is that there are no rashes in the nasolabial triangle. Passes in 3-7 days. Additional symptoms are severe sore throat, crimson tongue.

Meningitis

Terrible disease, accompanied by a rash in the form of hemorrhages caused by rupture of capillaries, which do not go away and do not turn pale when pressed. Additional symptoms are headache, vomiting, pain in the extremities, stiff neck. The disease develops rapidly and can be deadly. If you suspect meningitis, you need to urgently call an ambulance.

Impetigo (streptoderma)

Accompanied by large blisters with purulent contents. Treatment is with topical or systemic antibiotics.

Fungal eruptions

Caused by contact with a fungal infection, they are divided into keratomycosis (damage to the stratum corneum of the epidermis) and dermatophytosis (damage to the skin, hair and nails). Usually appear as red rings on any part of the body. Transmitted from sick animals and people.

Rashes caused by parasites

Scabies

It manifests itself in the form of pairwise located points between the fingers, in the inguinal folds, on the knees and elbows. Accompanied by severe itching and disturb the baby. The reason is the scabies mite. Special creams are usually prescribed, and all family members should be treated.

Allergic rashes

Urticaria

This is an acute allergic reaction in which raised red blisters quickly appear, similar to a nettle burn. It develops suddenly upon contact with an allergen, accompanied by severe itching. It has an acute and chronic character. Occurs with the use of food proteins, viral infections, insect bites and the use of drugs. In severe cases, it is accompanied by Quincke’s edema, which requires an ambulance call.

Atopic dermatitis

This is a genetically determined disease associated with a defect in the skin barrier. It is important to note that allergy is not the cause of its occurrence, but rather a consequence. Only in 30% of cases, atopic dermatitis is combined with food allergies. The rash in the baby is localized on the face, buttocks, torso, extensor surfaces of the limbs. It is manifested by redness and peeling, accompanied by itching. Exacerbation is provoked by various triggers – stress, infections, sweat, histamine liberator products, tobacco smoke, animal hair.

For treatment, special creams are used that restore the barrier function – emollients. They need to be used daily, plentifully lubricating the skin. In severe cases, hormonal ointments are prescribed.

Pseudo-allergic

A pseudo-allergic reaction looks like an allergic reaction, but in fact it is not, since its development does not have an immune mechanism. The reasons are an increased content of histamine in foods, the ability of foods to stimulate its release from mast cells, increased absorption of histamine due to gastrointestinal pathologies. Histamine liberators include strawberries, chocolate, cocoa, citrus fruits, cheeses, preservatives, colorants and flavor enhancers. In a breastfed newborn, they arise due to the use of these products by the mother. Treatment consists of a tolerable dose, skin care, and sometimes antihistamines.

Mechanical eruptions

Prickly heat

Appears in the form of small red spots when overheated. It may also look like nodules or vesicles, appears in the folds of the skin, on the face, head, trunk, limbs. The occurrence of prickly heat contributes to an increase in body temperature, overheating due to too warm clothes, the use of things made of dense fabric. Lasts from several hours to several days, air baths speed up the healing process.

To prevent prickly heat, do not wrap the baby while walking, dress according to the principle – plus one layer of clothing relative to an adult. During wakefulness, periodically undress the baby for air baths. If prickly heat has already appeared, choose looser clothes, bathe without soap and protect from overheating.

Contact dermatitis

This is skin damage due to prolonged exposure to various irritants – saliva, fruit and vegetable juices, detergents. In newborns, saliva often causes dermatitis near the mouth and on the neck. Passes when the irritant is eliminated, anti-inflammatory creams are sometimes prescribed.

Diaper dermatitis

Prototype contact dermatitis, only appears under a diaper. The cause is both overheating and contact with urine, sweat and feces. A rash in a baby occurs on the thighs, abdomen, buttocks in the form of red spots, bumps and peeling.

Treatment is carried out according to the abbreviation ABCDE (air, barrier, cleansing, diaper, education) – air, barrier, cleansing, diaper, education. With diaper dermatitis, you need to change diapers every 2-3 hours, arrange air baths when changing clothes, dry the skin thoroughly after bathing, and also lubricate with diaper cream. Sometimes local hormonal agents are used.

How to tell a rash from an allergy

An allergic reaction develops when an allergen enters the body. The immune system rushes to the defense, while blood vessels dilate, the skin turns red and inflamed, rashes appear, and swelling may develop. If there was no contact with the allergen, then the rash is most likely not allergic.

It is also worth distinguishing an allergic rash in an infant from an infectious one. With an allergy, it occurs suddenly, with an infection in stages – first it is localized in one place, and then it appears in another, it has clear boundaries of lesions. An infectious rash is contagious, so if one of the family members has it, then it is not an allergy. Viral or bacterial infections are often accompanied by fever, allergies are not. With an allergic rash, there is almost always severe itching, swelling, rhinitis, conjunctivitis may appear.

But still, it is very difficult to establish the cause on your own, so you should consult a doctor for the correct diagnosis and treatment. The doctor may prescribe tests to confirm a particular disease.

What to do if your child has a rash

A rash in a newborn baby can be of different etiologies, in some cases it goes away on its own, and in some it requires treatment. It is especially dangerous to miss formidable diseases such as meningitis or scarlet fever. Since eruptions often occur in greased molds, it is easy to make a mistake.

If simple methods like air baths, using breathable fabrics, frequent diaper changes, using emollients do not help, and even more so if the condition of the newborn worsens – the temperature rises, breathing is difficult, swelling has developed, the baby refuses to eat, urgently seek medical help .

When to see a doctor

In fact, it is better to show any rashes to the doctor. And do it in person, not by photo or video call. The doctor needs not only to examine the rash live, but also to feel, conduct certain tests, and also independently assess the condition of the child. If you find yourself in such a situation, you can contact our specialists.

Pediatricians of the Nashe Vremya clinic work in accordance with the principles of evidence-based medicine. They treat children with great care, carefully and carefully treat babies and are tactful with parents. Here they will not prescribe unnecessary tests, they will not make non-existent diagnoses, they will answer all questions, reassure and prescribe the correct treatment in case it is necessary.

If you want the baby to be examined at home, contact our field service. The pediatrician will arrive on the day of the call, after the examination he will give the necessary recommendations and will observe the baby until he is fully recovered.

We have specialists with extensive experience, as well as great love for their profession and little patients.

Prevention

To prevent rashes, the following measures should be taken:

• take care of the baby’s hygiene and wash hands before touching the baby
• monitor the cleanliness of the room, humidify and ventilate in time
• use loose, breathable clothing for the newborn
• avoid overheating and hypothermia of the child
• change diapers more often and take air baths
• limit the amount of contact other people have with the baby
• buy quality toys and baby care products
• if possible, invite a doctor to the house, and not come to the clinic yourself
• avoid contact with allergens
• keep the baby safe from insects

And the most important thing is to vaccinate both the child and others in a timely manner, especially if the child cannot be vaccinated due to age. For example, adults should be vaccinated against influenza or covid.

Methods of treatment

Treatment depends on the cause that caused the damage to the skin. First you need to see a doctor for an accurate diagnosis. Further, depending on the disease, antihistamines, hormonal ointments, emollients, antibiotics, antifungals can be prescribed.

And sometimes a rash in a newborn baby does not need to be treated at all, but just wait. But additional measures may be required – air baths, a comfortable indoor climate, breathable clothing, quality diapers.

Tips for parents

A rash in a baby is not an independent disease or its cause, it is always a symptom. Therefore, it is very important to determine what caused the rash in the baby – allergies, infections, insect bites or mechanical damage.

If the rash is accompanied by fever, the child is lethargic – urgently see a doctor, if hemorrhages appear – immediately call an ambulance! If the rash occurs against the background of the complete health of the child, see the pediatrician in a planned manner.

Terminals

The rash can manifest itself in the form of various elements – from small points to large blisters and hemorrhages. Types of rash in newborns, as well as their causes, can be completely different:

• physiological – neonatal acne, milia, toxic erythema
• pathological – viral, bacterial, fungal, allergic
• mechanical – prickly heat, contact dermatitis, diaper dermatitis

Therefore, it is important to understand what exactly caused this or that rash in an infant.

Most often, a rash on the body of a baby goes away on its own and does not need treatment, for example, a hormonal rash in a newborn. However, you need to be careful not to miss a serious illness.

It is difficult for parents to figure out the reasons themselves, so it is better to entrust this to a doctor. If the rash is not dangerous, calmly wait until it passes, and if it is the cause of some disease, establish it in time and start treatment.

Sources

1. Kudryavtseva A.V., Atopic dermatitis and food allergy: features of patient management in Russia and other countries (Europe, USA and Japan), School of atopic dermatitis as the basis for successful treatment of children, 2018.
2. Kudryavtseva A.V., Urticaria in children: pathogenetic mechanisms and possibilities of modern therapy, 2017.
3. Revyakina V.A., Urticaria in pediatric practice, 2007.
4. Clinical guidelines: Atopic dermatitis, 2020.
5. Pozdnyakova O.N., Reshetnikova T.B., Bychkov S.G., The structure of the incidence of dermatoses in newborns and infants with a burdened somatic history, 2019.
6. Bokova T.A., Diaper (diaper) dermatitis in a newborn: modern approaches to prevention and treatment, 2019.
7. Gorlanov I.A., Leina L.M., Milyavskaya I.R., Skin of newborns: differential diagnosis of pathological conditions, features of care, 2018.
8. Diagnosis and treatment of seborrheic dermatitis, Gary W Clark et al. Am Fam Physician, 2015.
9. An Overview of the Diagnosis and Management of Seborrheic Dermatitis Federica Dall’Oglio et al. Clin Cosmet Investig Dermatol, 2022.
10. Contact Dermatitis, Graham Litchman et al, 2022.
11. Contact allergy in children with and without atopic dermatitis: An Italian multicentre study, Domenico Bonamonte et al. Contact Dermatitis, 2022.

Skin rashes in babies – contraindications for vaccination

Dear Parents! On the day of the vaccination, your baby needs to see a pediatrician . Of course, the child must be healthy , he needs to measure his body temperature the night before and in the morning before leaving the house and examine the skin. In the presence of skin rashes, vaccination is most often delayed, as this is a contraindication for the administration of most vaccines . Therefore, we recommend that parents be careful about skin rashes in their baby and always discuss the cause of their appearance with health workers.

Due to the frequent occurrence at appointments before vaccination of situations when parents of babies do not pay attention to skin manifestations in a child and come to an appointment on the day of vaccination, we suggest that you familiarize yourself with the causes of skin rashes in children.

Since the most intensive vaccination schedule is available for children in the first year of life, we will consider the causes of rash in young children (up to 3 years). But even at an older age, parents should not neglect the rule – we vaccinate children against the background of complete health, the absence of acute manifestations of the disease, if there are indications – against the background of the necessary medical preparation, in most cases – against the background of following a hypoallergenic diet.

So, the causes of skin rashes in young children:

• Allergic rash
• Intertrigo (diaper rash)
• Prickly heat
• Eruptions on the skin due to parasitic infestations
• Rash in infectious diseases
• Hemorrhagic eruptions in diseases of the blood and vessels
• Insect bites

Allergic rash

The most common cause of rashes in children of the first year of life is food allergy, the manifestations of which are diverse:

• rash of different shape and brightness on the body, more often on the cheeks,
• redness, peeling of the skin, accompanied by itching,
• persistent diaper rash,
• gneiss on the scalp and eyebrows, persisting after the 3-4th month of a baby’s life,
• copious prickly heat with slight overheating,
• appearance on the skin of blisters similar to nettle burn (urticaria),
• the appearance of swelling of the skin, subcutaneous fat and mucous membranes (angioedema).

In recent years, the number of children with skin manifestations of allergies has been growing. An increased risk of food allergies exists in children in whose families cases of allergies have already been recorded. In the presence of allergic diseases on the part of both parents, the risk of allergies in a child is approximately 70–80%, in the presence of an allergic pathology on the part of the mother – 60%, on the part of the father – 30%, in the absence of allergic problems on the part of the parents – from 10 to 18 %. In addition to hereditary factors, allergic reactions in an infant can be caused by fetal hypoxia (oxygen deficiency) during pregnancy and childbirth, a quick transition to artificial feeding, acute respiratory viral and intestinal infections suffered by the baby, followed by a violation of the composition of the intestinal microflora.

The occurrence of food allergies in children of the first year of life is associated with the functional features of their digestive tract: low enzyme activity, low production of IgA – protective antibodies located on the surface of the mucous membranes of the gastrointestinal tract. They provide local protection of the intestinal mucosa from foreign agents. With the introduction of complementary foods (individually for each child – from 4-6 months of life), further maturation of enzyme systems occurs. In case of violation of the terms and rules for the introduction of complementary foods, fermentopathy, imbalance of the microflora in the intestine, the appearance of rashes on the skin associated with an inflammatory reaction in the intestinal wall, requiring correction and treatment, may occur.

And of course, allergic reactions in breastfed children are associated with eating disorders of the nursing mother, with her excessive consumption of highly allergenic foods.

The so-called food diary helps to identify the causative allergen, in which the mother regularly (at least 14 days) notes all types of food and drink received by her or the baby during the day, indicates the composition of the dishes, the features of their culinary processing, feeding time and the appearance of unwanted reactions ( loose stools, regurgitation, skin rashes, etc. ). In children after a year, rashes are noted on the introduction of foods such as sweets, chocolate, cakes, muffins and other industrial culinary products containing a large amount of dyes and preservatives, which often cause allergic manifestations on the skin, even in adults. Given the immaturity of the enzymatic systems of the digestive tract in young children, the immaturity of the immune system, these products are not recommended to be introduced into the diet of children under 3 years of age.

If your baby periodically has manifestations of food allergies on the skin, vaccination is postponed until the rash fades and is carried out against the background of taking antihistamines prescribed by a pediatrician or an allergist-immunologist a few days before and after vaccination. It is necessary to follow a hypoallergenic diet for a nursing mother and child at least 7-10 days before and after the proposed vaccination. According to the doctor’s prescription, probably, to stabilize the skin process, it will be necessary to use external agents to treat the skin so that vaccination does not serve as a factor that provoked an exacerbation.

Intertrigo (diaper rash)

Diaper rash usually appears in large folds of skin, especially where a child’s skin comes into contact with urine, feces, and diapers. Most often, diaper rash appears on the buttocks, in the inguinal-femoral folds, but sometimes the skin can turn red in a similar way in the axillary and cervical folds and even behind the ears. In advanced cases, cracks, erosions and sores may appear on the surface.

Prevention of diaper rash is the timely change of diapers and diapers, air baths. In case of diaper rash, the pediatrician, in accordance with the type of skin, will prescribe baths with decoctions of certain herbs, as well as a remedy for application after bathing in skin folds.

Prickly heat

Prickly heat is associated with the peculiarities of the structure and functioning of the sweat glands. Usually occurs in hot weather, when the child overheats due to fever, high air temperature or excessive wrapping.

Prickly heat appears on the skin with multiple small (1–2 mm) bright red spots. Rashes in babies often appear on the neck, chest and abdomen. The prickly heat of the baby practically does not bother, and if the rules of skin care are followed, it quickly disappears. Small manifestations of miliaria are not a reason for a medical withdrawal from vaccination if there are no infected elements.

Rashes on the skin due to parasitic infestations

In infants, more often from the age of 6 months, infection with various parasites is very likely – pinworms, giardia, roundworms. Toxins, waste products of parasites, helminths are absorbed into the blood and are an allergenic factor, in most cases they can cause rashes on the skin of a child.

Only a pediatrician can identify this type of rash after an examination and necessary examinations, after which treatment is prescribed individually.

Rashes in infectious diseases

If the rash on the skin is accompanied by fever, chills, runny nose, general malaise, loss of appetite, if there has been contact with patients in the family or in a public place for 7–14 days, the child is likely to have manifestations of infection.

Rashes occur with such infectious diseases as: chicken pox, measles, rubella, scarlet fever, infectious mononucleosis, meningococcal infection, enterovirus infection and other viral diseases. To make a diagnosis, an examination of a child by a pediatrician must be carried out at home or in a special box in a children’s clinic.

Hemorrhagic eruptions in diseases of the blood and vessels

In addition to infections, a rash occurs in diseases of the blood and blood vessels. Hemorrhagic rashes look like red or dark spots (bruises) that do not disappear when pressed. In the presence of a hemorrhagic rash, it is necessary to consult a pediatrician, a hematologist and conduct additional research methods.

Insect bites

Young children often suffer from mosquito and midge bites. Parents notice skin rashes in the morning, after the child wakes up or after walking in the forest park area. The appearance of pink or reddish spots is characteristic, mainly on open areas of the body, and the presence of elements on the face or on one half of it is obligatory (in the event that the child slept on his side).