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Infectious rashes in childhood

Last updated: May 6, 2021

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This article covers various infectious exanthems in childhood, including measles, scarlet fever, rubella, fifth disease, roseola infantum, chickenpox, and hand, foot, and mouth disease.

For more information on each specific condition, see the respective articles.

Overview of infectious rashes in childhood
Pathogen Appearance of exanthem Course of exanthem Other clinical features
  • Begins on the face, frequently behind the ears
  • Disseminates to the rest of the body
  • Fades after ∼ 5 days with brown discoloration and desquamation
Scarlet fever
  • Begins in the neck region
  • Disseminates to the head, trunk, and extremities
  • Brown discoloration and desquamation of the skin during the second to fourth week of infection
  • Begins behind the ears
  • Extends to the trunk and extremities
  • Symptoms usually disappear within 3 days
Fifth disease (erythema infectiosum)
  • Maculopapular
  • Initially confluent
  • Lace-like and reticular appearance over time
  • Becomes more pronounced after exposure to sunlight or heat
  • Slapped cheek appearance: flushed cheeks with perioral pallor
  • Can spread to extremities and trunk
  • Fades after ∼ 5–8 days
  • May be recurrent for several months following the initial infection
Roseola infantum (exanthem subitum)
  • Develops as the fever subsides
  • Originates on the trunk and may spread to the face and extremities
  • Frequently observed from only several hours to a maximum of 3 days

Chickenpox (varicella)

  • Vesicular rash on erythematous background
  • Starry sky: simultaneous occurrence of different stages (e.g., vesicles, crusted papules)
Hand, foot, and mouth disease
  • Affects feet and hands
  • Rarely generalizes
  • Fades after ∼ 4 days

Drug reactions should always be considered as a potential cause of a rash.