Rash - Widespread And Cause Unknown

DEFINITION

• Rash over large areas or most of the body (widespread or generalized)
• Occasionally just on hands, feet and buttocks - but both sides of body
• Red or pink rash
• Small spots, large spots or solid red skin

Causes

• Main cause: a 2 or 3 day rash occurring with a viral illness. Viral rashes usually have symmetrical pink spots on the trunk. 
• Other common causes: 5 rashes that you may be able to recognize are listed below. If you suspect one of them, go to that topic. If not, use this topic.

Return to School

• Most viral rashes are no longer contagious once the fever is gone.
• For minor rashes, your child can return to day care or school after the FEVER is gone.
• For major rashes, your child can return to day care or school after the RASH is gone or your doctor says it's safe to return with the rash.

See More Appropriate Topic (instead of this one) If

• CHICKENPOX
• HAND-FOOT-AND-MOUTH DISEASE
• HIVES (especially if itchy)
• SUNBURN
• Measles vaccine rash (fine pink rash occurring 7-10 days after measles vaccine), see IMMUNIZATION REACTIONS

WHEN TO CALL YOUR DOCTOR

Call 911 Now (your child may need an ambulance) If

• Purple or blood-colored rash with fever
• Sudden onset of rash (within 2 hours) and also has difficulty with breathing or swallowing
• Not moving or too weak to stand

Call Your Doctor Now (night or day) If

• Your child looks or acts very sick
• Purple or blood-colored rash WITHOUT fever
• Bright red skin that peels off in sheets
• Large blisters on skin
• Bloody crusts on lips
• Taking a prescription medication within the last 3 days
• Fever
• Menstruating and using tampons
• You think your child needs to be seen

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If

• Widespread rash, but none of the symptoms described above (Reason: needs a diagnosis)

HOME CARE ADVICE FOR WIDESPREAD RASHES (until you talk with your doctor)

1. For Non-Itchy Rashes: No treatment is necessary, except for heat rashes which respond to cool baths.
2. For Itchy Rashes:
3. • Wash the skin once with soap to remove irritants.
   • Hydrocortisone Cream: For relief of itching, apply 1% hydrocortisone cream (no prescription needed) 3 times per day to the itchy areas. 
   • Cool Bath: For flare-ups of itching, give your child a cool bath without soap for 10 minutes. (Caution: avoid any chill). Optional: Can add 2 ounces (60 ml) of baking soda per tub
4. Fever Medicine: For fever above 102°F (39°C), give acetaminophen (e.g. Tylenol) or ibuprofen.
5. Contagiousness:
6. • If your child has a fever, avoid contact with other children and especially pregnant women until a diagnosis is made.
   • Most viral rashes are contagious (especially if a fever is present).
   • Your child can return to day care or school after the rash is gone or your doctor says it's safe to return with the rash.
7. Expected Course: Most viral rashes disappear within 48 hours.
8. Call Your Doctor If:
9. • Your child becomes worse

Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

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Author and Senior Reviewer: Barton D. Schmitt, M.D.
Last Reviewed: 9/15/2011
Last Revised: 8/1/2011
Content Set: Pediatric HouseCalls Symptom Checker
Copyright 1994-2012 Barton D. Schmitt, M.D.