Viral Exanthem

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Introduction

Viral exanthem (VAI-ruhl eggs-AN-them) is the medical name given to the widespread skin rash that can come with a viral infection. These types of rashes are common in children and babies and are usually harmless.

Viral exanthem on child's body with itchy red spotty rash

Who gets it?

Viruses are a type of germ that cause infections such as the common cold, bronchiolitis, tonsillitis, ear infections, the flu, measles, mumps, chicken pox, and many other conditions. Colds are very common in healthy children. The average preschool child will get at least six colds each year. Your child can catch a virus if they come into contact with another child with the virus, so often there may be other children affected at the same time.

What causes it?

The rash can be caused by the virus itself or by your body fighting the virus. Certain viral infections can cause particular patterns of rashes, such as:

Chicken pox
Measles
Rubella
Roseola
Slapped cheek or parvovirus

For the rest of the several hundred other viruses, the rashes can all look very similar.

What does it look and feel like?

Signs and symptoms can be different depending on the virus that causes them. If your child has a rash of small bright red or purple spots or bruises that do not turn white (blanch) when you push on them along with a fever, headache, stiff neck or back or if your child looks unwell, seek urgent medical advice from a GP or nearest hospital emergency department.

Looks like…

Viral exanthem can look like red spots or blotches; they can be flat or bumpy, look like welts or blisters, or any combination of these
The rash can be on any part of your child's skin but are usually most obvious on the tummy and back
Sometimes the virus causes changes inside the mouth. This is known as enanthem.
Certain viral infections can cause unique types of rashes that are helpful in diagnosing the virus. Features like unusual colour, blistering, the body part it affects, spots in the mouth, appearance after starting an antibiotic, and red eyes can be helpful hints about which virus is causing the rash

Feels like…

The rash can be itchy
In most cases, your child will have had symptoms of a viral illness before the rash appears, such as muscle aches, irritability, abdominal pain, fevers, feeling tired, and headaches

What tests might be needed?

Most viral exanthems have a typical pattern or symptoms which allows your child's doctor to make a diagnosis without any extra tests. However in most cases, it is not important to find out which virus is causing the rash as they are generally benign and resolve on their own. In a few instances, the doctor may need to do a viral throat/nose swab, a swab of the rash, and sometimes a blood test. Very rarely, a biopsy is required, where a piece of your child's skin is taken to look under the microscope to confirm the diagnosis.

What treatments are available?

What can I do?

Regular children's paracetamol (Panadol) to reduce fever as well as help with any headache and body aches
Fragrance-free moisturiser to help with the itch
Viral infections are contagious so keep your child at home from school and childcare to prevent it spreading to other children and vulnerable people.
Always ensure your child’s immunisations are up to date to prevent getting viral illnesses such as measles, rubella, and varicella

Medical therapies

Certain viruses may require specific treatment, but most cases do not require medical treatment

What happens after treatment?

In most cases the rash will clear on its own. However, it can last for several days or sometimes weeks. They do not usually cause any long-term problems.