Childhood
RashesChildhood rashes are common and there are traditionally the six
major ones as follows: Measles, rubella,chickenpox, scarlet fever, the Fifth disease
and Erythema subitum. Here are more details.
Measles Measles
is a highly contagious viral infection that had an important historical significance
when the settlers came from Europe and brought this infectious disease with them
into a population that had not had any exposure to it in the past. Here is an
image of a child with measles.
Rubella This
viral infection, also known as "German measles", is caused by the rubella
virus. It is feared because it can lead to miscarriages (=spontaneous abortions),
to death of a fetus and to congenital defects in the affected fetus. Here is an
image of a rubella
(German measles) rash. Chickenpox Chickenpox
is an infectious illness in children where characteristic skin lesions erupt all
over the body. It is due to the varicella-zoster virus that also causes shingles
(=herpes zoster) in older children and adults. This virus belongs into the herpes
family of viruses and is called "human herpes virus, type3". Here is
an image of a young man affected
by the rash. In the beginning the rash starts with blisters, two or three
days later these break open, get super-infected with skin flora and crust over.
The secretions and the crusts are infective as they contain virus.
Scarlet Fever Scarlet fever has become rare in the US,
but is still very common in less developed countries. It is caused by the pyrogenic
toxin produced by the group A streptococcus family (Streptococcus pyogenes). This
toxin causes all of the symptoms of scarlet fever including the characteristic
skin rash, joint or heart disease, kidney damage or seizures. Here is an image
of a child with
scarlet fever . Fifth
disease The fifth disease is also called erythema infectiosum among
physicians. It is called fifth disease as it is one of the common five childhood
infections apart from measles, rubella, scarlet fever and chickenpox. It is called
erythema infectiosum, Latin for “infectious rash” because it is an infection
with a virus (parvovirus, type B19). It is usually faster and less disabling than
all of the other childhood rashes. It is common in the age group of 5 to 7 years
and is caused by mini epidemics in late winter / spring in the northern hemisphere.
Incubation time is 4 to 14 days. In the beginning it presents like a cold and
flu-like illness. An erythematous rash occurs in the cheeks
and a blotchy red rash appears on the extremities and trunk, but spares the soles
and the palms. The lesions are maculopapular (red and raised) and flow into each
other. Along with this the patient may have joint pains, which are more common
in adults. The illness lasts about 5 to 10 days. In a person with a normal
immune system this is a self-limiting viral illness and no treatment is required.
However, in the immunocompromised person or in people with anemia due to sickle
cell disease the viral phase of this B19 parvovirus infection can be prolonged.
In pregnancy this infection . although harmless for the mother , is devastating
to 50% of the offspring. Less than 10% of fetal infections lead to fetal death.
Others are born with severe anemia or a conditions called hydrops
fetalis. In the US about 50 to 80% of adults have antibodies to parvovirus
B19 meaning that they were exposed ion the past and either had the fifth disease
or were exposed, but did not get the rash. Women in childbearing age should stay
away from any infectious child or adult. Blood tests can be done to determine
whether the woman is immune. Frequent hand washing is advisable during a late
winter/ spring epidemic. In some cases hyper immune globulin injections have been
successfully been used.
Erythema subitum A similar rash, called exanthema subitum
(sixth disease or roseola infantum) is very similar to the fifth disease, but
is caused by the human herpesvirus 6 (genus roseolavirus). This is characterized
by a very high fever of 41°C (106°F). This will last 3 to 5 days and when the
fever breaks a generalized rash starts on the trunk
and then all over the body. The children affected are mostly in the young age
group, particularly ages 6 to 12 months, and by the 2nd year about 65 to 100%
show seroconversion meaning that they have been exposed to it. The only significance
is the high fever that needs to be treated symptomatically with cold compresses,
frequent cool baths and acetaminophen (Tylenol). Occasionally there may be seizures,
meningoencephalitis (rare) or hepatitis in which case a referral to a pediatrician
is needed. This viral disease is otherwise self limiting and resolves in most
without any complications.
|
