Allergic rash in the child

Allergic rash in a child is one of the most common types of reaction to an allergen from the immune system and skin. A similar rash in clinical practice is called an allergic urticaria or urticaria (from the Latin urtica - nettle). A characteristic clinical symptom of an allergic rash is localized at certain sites or spread over the body of papules. The rash looks like painless, but itchy erythematous blisters, which in children are most often provoked by food allergens.

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Causes of an allergic rash in a child

Factors that provoke allergies, the causes of allergic rash in a child are grouped into the following groups: 

• Medicinal allergens.
• Food allergens.
• Physical factors (sun, overheating, cold).
• Chemical factors (household chemicals, washing powders and so on).

Breast children are most often prone to food allergy, which is characterized by skin manifestations, older children may suffer from drug allergies, hay fever or rashes caused by ultraviolet radiation (sun).

Among the foods most allergenic are all types of citrus, seafood, chocolate, cocoa, strawberry, and an allergic rash can cause intolerance to milk protein.

Causes of an allergic rash in a child

Type of allergy	Allergens
Foodstuffs	Milk protein, dairy products, mixtures Fruits, especially citrus fruits Vegetables (red, yellow, orange skin color, pulp) Sea fish, seafood Eggs Products from wheat porridge Honey Poultry meat (chicken) Nuts Products containing preservatives, dyes, flavors
Medicamentous	Preparations of penicillin group Preparations of the sulfanilamide group Vitamins of group B NSAIDs are non-steroidal anti-inflammatory drugs Anticonvulsants Preparations for X-ray diagnostics (contrast agents)
Aeroallergy	Household dust Household chemicals in aerosol form Wool of animals Pollen

It should be noted that the cause of urticaria in a child may be viral, bacterial infections, as well as parasitic infestations, but such rashes are not classified as allergic, despite the similarity of clinical manifestations.

According to children's allergists, in the list of "provokers" of an allergic rash in children food allergens, especially dairy products, sea fish, and eggs, that is, those that contain protein, are leading. These factors cause an indirect reaction in which antibodies of IgE immunoglobulins are involved. Allergens of fruits and vegetables in orange, red cause a direct release of histamine, without the involvement of IgE.

Allergic urticaria in an acute form, provoked by aerosfactors (household chemicals, pollen), is most often found in children over 3 years of age and is a symptom of cross-sectional polyvalent allergy.

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Symptoms of an allergic rash in a child

The main signs of allergic rashes in children are as follows: 

• Erythema (redness) of certain areas of the skin.
• There is a slight puffiness at the site of the rash.
• Small papules are vesicles.
• Itching, sometimes very strong.
• Irritability, tearfulness.
• If the papules burst, there may be erosive wounds filled with exudate.
• With food allergy localization on the skin of the face (cheeks), buttocks, calf legs, less often on the forearms.

Symptoms of an allergic rash in a child depend on the form of the underlying disease - allergies, which can be chronic or acute. 

1. The acute form of allergy most often develops as a reaction to a food allergen or a medicamental factor. Allergic rash looks like papules, rarely large blisters, localized on the skin of the face, forearms. Bubble formations are painted in pink, soft color, cause characteristic itching and irritation. The acute form of allergy manifests itself mainly on the upper half of the child's body, and the rash can also be located in large folds (inguinal). The child is capricious, starts combing the itchy skin, loses appetite, does not sleep well. Against the background of general irritability, vomiting, dyspeptic manifestations is possible. 
2. If the allergy exhibits symptoms for a long time, and the rash does not go away after 4-6 weeks, such rashes are diagnosed as a chronic allergic rash. Symptoms of it are similar to acute manifestations of allergy, however, cause more aggravated manifestations of the nervous system - insomnia, nervousness, irritability, loss of body weight due to refusal of food.

Symptoms of an allergic rash can manifest in the form of angioedema (Quincke), which is considered the most dangerous and is characterized by the rapid development of the following symptoms:

• Tingling sensation in the tongue, in the lips or in the sky.
• Pain, colic or cramping in the abdomen.
• Erythematous rash, often on the face.
• The rash on the face quickly spreads and is accompanied by developing puffiness.
• Eyelids and mucous membrane of the mouth swelling just before our eyes.
• Possible conjunctivitis.
• Edema can spread (migrate) to the nasopharynx and cause difficulty breathing.
• The facial skin acquires a characteristic cyanotic shade (cyanosis).
• Angioedema is a serious threat to life and requires immediate medical attention to avoid serious complications.

Allergic rash in an infant

The most common symptom of food allergy in newborns who are on artificial feeding is urticaria, which is often called diathesis. In fact, the diagnosis of "diathesis" does not exist, this word means predisposition, a tendency to any illness. Allergic rash in an infant is a variant of transient, non-pathological dermatitis, when the baby's skin reacts to the invasion of an antigenic substance. There are three ways in which an allergen is introduced into an unprepared, unadapted child's organism: 

• During feeding, that is a food allergen.
• During contact with the skin, a contact allergen.
• During breathing - aeroallergen (inhalant allergen) or the respiratory route.

Allergy in children up to a year is most often provoked by a food factor. If a child is breastfeeding, he may have similar problems in cases where the mother does not comply with the hypoallergenic diet. A child receiving artificial mixtures reacts to the protein of cow's milk, too early or ill-conceived from the point of view of nutritional nutrition.

Allergic rash in an infant is currently extremely common, according to statistics, it affects up to 45% of babies under the age of one and a half years. In the etiology of food allergies in neonates an important role is played by the hereditary factor: 

• If mom and dad are allergic, the probability of allergy in their offspring is up to 65%.
• If allergik - one of the parents, the risk of allergic reaction reaches 40%.

In addition, the cause of an allergic rash can be and intrauterine congenital pathology (hypoxia), diseases that the mother suffered during pregnancy

Physiologically, the allergic reaction is explained by the insufficient formation of the digestive tract of the baby and the low activity of production of protective antibodies - IgA. Thus, local protection of the mucous membranes of the gastrointestinal tract with the help of immune antibodies is practically absent, and allergic substances quite easily penetrate into the bloodstream, overcoming the intestinal barrier.

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How does an allergic rash appear in an infant?

First on the allergen reacts skin integument of the child: 

• Redness of the cheeks, less frequently of the forehead or neck.
• Diffuse or localized rash, often starting from the face. It is possible to migrate the rash to the forearms, buttocks and calves of the legs.
• Harshness, peeling of the skin of the face.
• Constant intertrigo, not associated with objective hygienic causes.

The most serious and threatening manifestation of allergies in a baby is angioedema or Quincke's edema, which develops very quickly and requires immediate action to stop it. The symptoms of Quincke's edema in newborns are very specific: 

• The child suddenly starts to be capricious, to cry.
• On the skin of the face appear small papules (rash).
• The baby's voice becomes husky, intermittent.
• Appears shortness of breath, possibly interrupting breathing.
• The child quickly develops a laryngeal edema.
• The face is painted in a characteristic cyanotic shade (cyanosis), then it suddenly turns pale.

At the slightest alarming symptoms, which a caring mother notices from her baby, one should consult a doctor. The choice of the method of diagnosis and therapeutic actions is the prerogative of the treating pediatrician or allergist, parents must strictly follow the medical recommendations.

What should I do to prevent an allergic rash in an infant and not recur? 

• The introduction of complementary foods must be agreed with the pediatrician, a nutritionist, especially if there is a risk of developing allergies due to a hereditary factor.
• The first lure should be hypoallergenic, even for those kids who have not previously had allergy symptoms.
• Whole cow milk, eggs and dishes containing them, wheat cereals, citrus fruits, nuts - these are the products that it is better not to give the baby to a year and a half.
• Breastfeeding mother should observe a special hypoallergenic diet.
• A kid, who has periodic constipation, may respond to a stool with an allergic rash. Therefore, the child needs to adjust the timely emptying of the digestive tract.
• For hygienic purposes, skin care for a baby, it is necessary to use only hypoallergenic, special cosmetics that do not contain perfume fragrances, fragrances, dyes.
• An allergic contact rash can be triggered by chlorinated water for bathing, so the baby is better to bathe in dechlorinated or boiled water at the right temperature.
• Allergies can be caused by clothing, bedding made of synthetic materials, this factor should be excluded.
• Thermal allergies can be triggered by overheating and too warm clothes. The baby should not be excessively wrapped up, since the body temperature of newborns is higher than the normal temperature of an adult, and the heat exchange mechanisms are arranged differently.
• It should be excluded, or minimize the contact of the child with domestic animals, on the coat of which allergy may develop as a rash.

Allergic rash in an infant is a transient phenomenon. The kid is growing, all metabolic and protective functions of the digestive tract, liver, and immune system are also developing and improving. With age, almost all the symptoms of food allergy disappear, if the anti-allergic measures were carried out in a timely manner and in full. According to statistics, only 1-1.5% of children remain allergic to adulthood, most of them have a hereditary predisposition to allergies.

Diagnosis of an allergic rash in a child

The main clinical sign that allows to differentiate an allergic rash from infectious rashes is the relatively normal general condition of the baby. With all the nervous manifestations - moods, irritability, associated with itching skin, the child's appetite remains at the same level, the body temperature, as a rule, does not increase.

Diagnosis of an allergic rash in a child suggests such actions: 

• Collecting a thorough medical history, including allergic and family history, to exclude a possible hereditary factor.
• To confirm allergic urticaria, you must exclude other allergic, infectious, inflammatory diseases, which also have an association with IgE immunoglobulin.
• A detailed analysis of the pathway of allergen penetration is carried out, all possible causes are clarified, among which there may be household, contact factors.
• As a diagnostic and at the same time therapeutic measures, the supposed allergic factor is eliminated. If there is information about provocative food, all dishes containing an allergen are excluded, if the contact path of allergy development is suspected, dust, wool, synthetic detergents, cosmetics, and laundry are eliminated.
• If the disease occurs in an acute form, the diagnosis of an allergic rash in a child involves laboratory tests of blood to determine IgE in the blood serum.
• After the symptomatology subsides, as a rule, after 1.5-2 months, it is possible to conduct skin tests, tests (scarification, prik-tests, application) in order to more accurately determine the nature of sensitization and identify the allergen.
• A sign of an allergic rash, urticaria in a diagnostic sense are an increased level of T-lymphocytes, CIC (circulating immunocomplexes), a decrease in IgA titers, an increase in interleukin.

Diagnosis of allergic skin rashes in toddlers is carried out taking into account all the features of the state of health, the history and clinical symptoms of the disease.

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Treatment of an allergic rash in a child

Therapeutic actions against allergic rashes - this is the standard scheme for the treatment of allergies, including food, contact or medication.

1. Immediate elimination of the alleged provoking factor. Food liberators (provocators) of histamine can be dairy products, eggs, fruits or vegetables, as well as food containing vasoactive amines - sausages and other sausages, liver (pork), herring, tomatoes, hard cheese, smoked foods and sauerkraut. 
2. Antihistamines for the treatment of rashes should be recommended, appoint a pediatrician. As a rule, H1-blockers are prescribed in a dosage and form appropriate to the child's age. If the symptoms develop rapidly and become menacing (Quincke's edema), the doctor can apply glucocorticosteroids. 
3. As an emergency aid to a child who does not require a prescription, Fenistil gel (used from 2 months), Bepanten, which will soften the skin and relieve itching, or a simple baby cream, will do. Infusions and decoctions of medicinal herbs should be used only on the advice of the pediatrician, since many phyto-drugs are allergens.
4. An obligatory stage in the treatment of allergic rash is a diet that excludes provocative products. Hypoallergenic diet should be observed for 3 months even when the symptoms subsided. Further, products from the risk group are included in the menu with the utmost caution in microdoses, so as not to provoke a relapse of the allergic rash.

In the room where the child is, a certain sanitary and hygienic regime must be observed: 

• repeated wet cleaning,
• airing, 
• daily change of linen, clothes,
• it is necessary to exclude all provoking funds from the category of household chemicals.

Treatment of an allergic rash in a child involves a long-term observation by the attending physician or allergist. Clinical dispensary is not needed, however, monitoring of the baby's condition is carried out within six months after the first allergic manifestations are stopped.

Prevention of allergic rash in the child

Preventive measures for the prevention of allergies in children according to apt expression of pediatricians should begin in a year, and preferably two before the birth of a child. This means that the future mother, as well as the father, should monitor their health so that their baby is born healthy and does not suffer from allergies.

A pregnant woman should remember about compliance with a hypoallergenic diet and the possible risk when taking various medications. 

• Breastfeeding mother is the first potential source of food allergies in a baby, even a minimal dose of a food-borne liberator (an allergic provoker), eaten by a mother, will cause a reaction in an infant. Nuts, chocolate, sea fish, citrus fruits, eggs, smoked foods and canned products may be attractive in terms of taste, but they are also the main culprits for food allergies and rashes in a baby breastfed. 
• Children who have intolerance to milk protein should receive hypoallergenic mixtures and adhere to a diet of up to 2 and sometimes 3 years. 
• Children with a burdened hereditary allergic anamnesis should receive complementary foods on a special, individual scheme that takes into account all possible risks. 
• If an allergic rash has manifested itself, and it has been managed in time to stop, in order to avoid relapses, parents should maintain a special food diary. In these records, the slightest disturbing reactions to food or new lure are noted. Thus, the diary is an opportunity to warn in time, or stop the development of allergies. 
• A child prone to allergic rashes should not contact with animal hair, inhalant allergens - pollen, aerosols, household dust. 
• The vaccination calendar of the allergic child is different from the schedule for vaccinating a healthy child. Vaccinations should be carried out taking into account an allergic anamnesis. 
• Clothes, baby underwear should be made of natural materials. Also from the environment of the baby it is necessary to exclude toys made of latex, plastic without marks "hypoallergenic" and so on.

Prevention of allergic rash in a child is compliance with medical recommendations and the use of only pharmaceutical preparations, both internal and external. Self-medication, experiments with the treatment of an allergic rash in a baby can lead to serious complications.