A rash without itching in a baby

In most cases, rashes on the skin of children cause a sensation of itching, but it is also possible to have a rash without itching in a child. When does it happen, that is, what diseases are accompanied by rashes that are not itchy?

Causes of the an itchless baby rash

Skin rash (exanthema) and pruritus (pruritis) are clinical symptoms of many infectious and dermatologic diseases, as well as some systemic pathologies, including those of an autoimmune nature.

The causes of skin rashes in a child, in which itching is absent, are also numerous and varied.

In infants, it can be not only overheating-related crystalline sweating in a child with transparent vesicles (small vesicles containing serous exudate), but also the appearance of maculo-papular (spotty-nodular) or maculo-vesicular (spotty-pubescent) red rashes on the skin - manifestations of toxic erythema neonatalis, which is considered idiopathic. [1] For more information, see. - Erythema of the skin of newborns

A patchy nodular rash on the neck and trunk after several days of high fever in a child is a symptom of infantile roseola (sudden exanthema or sixth disease), which is the result of infection by the human herpes viruses HHV-6 or HHV-7.

Other viral infections that can cause a rash without pruritis include:

• Rubella virus - virus rubella 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, there is no itching; [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 ear flaps), 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 widespread infectious disease are detailed in the publication - Measles in children.
• Epstein-Barr virus (herpes virus HHV-4) 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 virus A16 (belonging to the enterovirus genus) 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 - may be seen in lesions from viruses Coxsackie and ECHO infections in children, as well as in most forms of infectious erythema, such as infectious erythema of Gianotti-Crosti. [7]

Coxsackie virus, HHV-6, HHV-5 (cytomegalovirus) and parvovirus B19 are associated with the development of papular acrodermatitis in children. Symmetrically arranged red rashes (consisting of papules and vesicles) that may coalesce, but do not itch, appear and persist for several weeks on the extensor surfaces of the arms and legs, forearms and thighs.

Molluscus contagiosum poxvirus infection can occur by contact (direct or indirect). This results in the development of a type of chronic viral dermatosis, such as molluscus contagiosum, which is characterized by a rash in a child without fever and itching on the face and all over the body. Very often in children localized molluscum contagiosum on the eyelid. The rashes are white, pinkish or flesh-colored raised dense papules (2-5 mm in diameter). [8]

Less common causes of rashes without itching in children include:

• Systemic vasculitis (inflammation of skin vessels) - Behçet's disease in children with rashes in the form of hyperemic nodules; [9]
• Purpura or Schoenlein-Genoch disease, related to hemorrhagic cutaneous vasculitis, affects the capillaries of the skin; a symmetrically arranged hemorrhagic rash engulfs the extremities (extensor surfaces), back, buttocks, and abdomen; [10]
• Juvenile polyarteritis nodosa and dermatopolymyositis; [11]
• Idiopathic ring-shaped granuloma. [12]

Risk factors

Specialists consider only risk factors for the development of diseases, the symptom of which is a skin rash, not accompanied by itching. And such factors are recognized: prematurity of the child, insufficient hygiene and poor sanitary and living conditions, 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, mucosa of the oropharynx, upper respiratory tract, or intestines are invaded by viruses, viruses spread through the lymph and bloodstream and then begin to divide and accumulate viral RNA - multiplication with the release of toxins.

Viruses that lead to 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 - to neutralize them with the help of recruited immune cells (T-lymphocytes, cytokines, macrophages, etc.). This leads to the destruction of damaged epithelial cells, capillary dilation and the development of a local inflammatory response.

More information in the articles:

• Herpesvirus infections
• What provokes systemic vasculitis?
• Schoenlein-Genoch disease Causes and pathogenesis

Complications and consequences

In crystalline sweating or toxic erythema of newborns, a complication may be the attachment of secondary bacterial infection (staphylo or streptococcal) with the formation of pus-filled blisters, and then - erosion of skin areas.

A rash provoked by the molluscum contagiosum virus may become itchy and painful, and the skin at the site of the rash may become red or swollen.

In children with Behçet's disease, the consequences of rashes can be manifested by skin ulceration, and when they heal - the formation of deep scars.

Diagnostics of the an itchless baby rash

In addition to anamnesis, physical examination and skin examination, diagnosis includes blood tests: general clinical, biochemical, immunologic - for specific antibodies (IgM and IgG) to viruses.

Also, absolutely all symptoms that occur with rashes must be taken into account.

Instrumental diagnosis consists of dermatoscopy.

Differential diagnosis

Differential diagnosis helps the pediatrician or dermatologist to determine the etiology of rashes to choose the right treatment tactics.

Treatment of the an itchless baby rash

By the way, in children, a rash without itching quite often passes on its own, and the treatment, as such, consists in the appointment of antipyretics for high fever, in particular, from the group of NSAIDs (Ibuprofen, etc.).

Such tactics are followed by pediatricians in erythema of newborns, rubella, infectious mononucleosis; in infectious erythema of viral etiology; in hand-foot-mouth syndrome (usually prescribe the reception of vitamins B1 and B2); in measles may be prescribed vitamin A.

In cases of sweating rashes can be washed off with a cream with provitamin B5 -dexpanthenol (Bepanten, Pantestin, D-Panthenol). Positive result gives and treatment with herbs: the child is bathed in water with the addition of decoction of chamomile pharmacy, succession three-divided, drug lover. And in the development of enteroviral vesicular stomatitis with exanthema for mouthwash is recommended to use decoctions of sage or calendula flowers.

In molluscum contagiosum in children, topical therapy is used: 5% alcoholic iodine solution, 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).

The main medications for Behcet's disease are systemic corticosteroids and the cytostatic drug Cyclophosphamide.

Also read:

• How to treat a skin rash
• Ointments for skin rashes
• Sweating in a child: what does it look like, how to treat at home?
• How is polyarteritis nodosa treated?

Prevention

Prevention of rubella is vaccination; against other viral infections mentioned above, only observance of the rules of personal hygiene and quarantine will protect: healthy children should not come into contact with a sick child, adults and children should wash their hands with soap and water more often, etc.

Forecast

Rash without itching in a child passes, but the overall prognosis of the outcome of the underlying disease depends on its etiology and the severity of other symptoms.