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Rash without itching in a child
Last reviewed: 23.04.2024
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In most cases, skin rashes in children cause an itchy sensation, but a rash without itching in a child is also possible. When does it happen, that is, what diseases are accompanied by non-itchy rashes?
Causes of the rashes without itching in a child
Skin rash (exanthema) and itching (pruritis) are clinical symptoms of many infectious and dermatological diseases, as well as some systemic pathologies, including autoimmune ones.
The causes of skin rashes in a child, in which there is no itching, are also numerous and varied.
In infancy, it can be not only crystalline miliaria associated with overheating in a child with transparent vesicles (small vesicles containing serous exudate), but also the appearance on the skin of maculo-papular (spotty-nodular) or maculo-vesicular (spotty-bubble) rashes red color - manifestations of toxic erythema of newborns, which is considered idiopathic. [1]For more details, see - Erythema of the skin of newborns
A patchy-nodular rash on the neck and trunk after several days of severe fever in a child is a symptom of roseola infantum (sudden exanthema or sixth disease), which is the result of infection with human herpes viruses HHV-6 or HHV-7.
Other viral infections that can cause a rash without pruritis include:
- Rubella virus - rubella virus in children , which is manifested by small red rashes on the skin of the face, quickly moving to the body and gradually disappearing after three to four days. In most cases, itching is absent; [2]
- Morbilli virus is a virus that causes measles, in which a patchy-nodular red rash appears on the skin of the face, neck (behind the auricles), in the folds of the limbs without itching in a child. There is a gradual merging of its individual elements. [3] The first signs and other symptoms of this common infectious disease are detailed in the publication - Measles in Children
- Epstein-Barr virus (HHV-4 herpes virus) leads to the development of infectious mononucleosis - with a red rash, fever, muscle and joint pain and symptoms of acute tonsillitis; [4]
- enterovirus A71 of the Picornaviridae family and Coxsackie A16 virus (belonging to the genus of enteroviruses) cause infectious erythema in infants and young children - enteroviral vesicular stomatitis with exanthema or hand-foot-mouth syndrome . [5], [6]
A medium-sized or smaller rash without itching in a child - in the form of spots or nodules - can be observed with Coxsackievirus and ECHO infections in children , as well as with most forms of infectious erythema , for example, Gianotti-Crosti infectious erythema. [7]
With Coxsackie viruses, HHV-6, HHV-5 (cytomegalovirus) and parvovirus B19, experts associate the development of papular acrodermatitis in children. With it, on the extensor surfaces of the arms and legs, on the forearms and thighs, symmetrically located red rashes (consisting of papules and vesicles) appear and persist for several weeks, which can merge, but do not cause itching.
By contact (direct or indirect), infection with the poxyvirus Molluscus contagiosum can occur. As a result, such a type of chronic viral dermatosis develops as molluscum contagiosum , which is characterized by a rash in a child without fever and itching on the face and throughout the body. Very often in children, molluscum contagiosum is localized on the eyelid . The lesions are white, pinkish, or flesh-colored, raised, firm papules (2–5 mm in diameter). [8]
Less common causes of a rash without itching in children are:
- systemic vasculitis (inflammation of the skin vessels) - Behcet's disease in children with rashes in the form of hyperemic nodules; [9]
- purpura or Schonlein-Genoch disease , related to hemorrhagic cutaneous vasculitis, affects the capillaries of the skin; symmetrically located hemorrhagic rash captures the limbs (extensor surfaces), back, buttocks, abdomen; [10]
- juvenile nodular polyarteritis and dermatopolymyositis; [11]
- idiopathic granuloma annulare . [12]
Risk factors
Specialists consider only risk factors for the development of diseases, the symptom of which is a skin rash that is not accompanied by itching. And such factors are recognized: prematurity of the child, insufficient hygiene and poor sanitary living conditions; a weakened immune system and a tendency to allergic reactions; genetic predisposition; frequent infections, the presence of infectious foci in the body and chronic inflammatory processes.
Pathogenesis
When the skin, mucous membrane of the oropharynx, upper respiratory tract or intestines are affected by viruses, they spread through the lymph and bloodstream, and then the division and accumulation of viral RNA begins - reproduction with the release of toxins.
Viruses that cause rashes are epitheliotropic infections. And the pathogenesis of the rash is due to the fact that under the influence of these antigens, cellular immunity is triggered - in order to neutralize them with the help of recruited immune cells (T-lymphocytes, cytokines, macrophages, etc.). This leads to the destruction of damaged epithelial cells, the expansion of capillaries and the development of a local inflammatory reaction.
More information in the articles:
Complications and consequences
With crystalline miliaria or toxic erythema of the newborn, a complication may be the addition of a secondary bacterial infection (staphylococcal or streptococcal) with the formation of pus-filled blisters, and then erosion of skin areas.
The rash caused by the molluscum contagiosum virus can become itchy and painful, and the skin at the site of the rash may be red or swollen.
In children with Behçet's disease, the consequences of the rash can be manifested by skin ulcerations, and when they heal, the formation of deep scars.
Diagnostics of the rashes without itching in a child
In addition to anamnesis, physical examination and skin examination , diagnosis includes blood tests: general clinical, biochemical, immunological - for specific antibodies (IgM and IgG) to viruses.
It is also necessary to take into account absolutely all the symptoms that occur during rashes.
Instrumental diagnostics consists in carrying out dermatoscopy .
Differential diagnosis
Differential diagnosis helps a pediatrician or dermatologist determine the etiology of the rash in order to choose the right treatment tactics.
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Treatment of the rashes without itching in a child
By the way, in children, a rash without itching quite often goes away on its own, and treatment, as such, consists in prescribing antipyretics at high temperatures, in particular, from the group of NSAIDs (Ibuprofen, etc.).
This tactic is followed by pediatricians with erythema of the newborn, rubella, infectious mononucleosis; with infectious erythema of viral etiology; with hand-foot-mouth syndrome (usually prescribed vitamins B1 and B2); Vitamin A may be prescribed for measles.
In cases of prickly heat, rashes can be washed off with a cream with provitamin B5 - dexpanthenol (Bepanthen, Pantestin, D-Panthenol). A positive result is also given by herbal treatment: the child is bathed in water with the addition of a decoction of chamomile, a series of tripartite, medicinal lovage. And with the development of enteroviral vesicular stomatitis with exanthema, it is recommended to use decoctions of sage or calendula flowers for rinsing the mouth.
For molluscum contagiosum in children, local therapy is used: 5% alcohol solution of iodine, 5% potassium hydroxide solution, salicylic ointment, 0.05% Tretinoin gel with trans-retinoic acid (which should not be applied to rashes in the eyes, mouth and nose).
Main drugs for Behçet's disease: systemic corticosteroids and the cytostatic drug Cyclophosphamide .
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Prevention
Rubella prevention - vaccination; against other viral infections mentioned above, only compliance with the rules of personal hygiene and quarantine will protect: healthy children should not come into contact with a sick child, adults and children need to wash their hands with soap more often, etc.
Forecast
A rash without itching in a child resolves, but the overall prognosis of the outcome of the underlying disease depends on its etiology and the severity of other symptoms.