A rash without itching in a baby

In most cases, skin rashes in children cause itching, but it is also possible for a child to have a rash without itching. When does it occur, that is, what diseases are accompanied by non-itchy rashes?

Causes of an itchless baby rash

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 reasons for the appearance of skin rashes in a child, in which there is no itching, are also numerous and varied.

In infancy, this may not only be a crystalline miliaria in a child with transparent vesicles (small bubbles containing serous exudate) associated with overheating, but also the appearance of maculopapular (spotted-nodular) or maculo-vesicular (spotted-vesicular) red rashes on the skin - manifestations of toxic erythema of the newborn, which is considered idiopathic. [ 1 ] For more details, see - Erythema of the skin of newborns

A maculopapular rash on the neck and trunk after several days of high fever in a child may be a symptom of roseola infantum (exanthema exanthema or sixth disease), which is caused by the 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 manifests itself as 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 spotty-nodular red rash without itching appears on the skin of the face, neck (behind the ears), in the folds of the limbs in a child. A gradual merging of its individual elements is observed. [ 3 ] The first signs and other symptoms of this common 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 Coxsackievirus A16 (belonging to the genus enterovirus) cause infectious erythema - enterovirus vesicular stomatitis with exanthema or hand-foot-and-mouth disease in infants and young children. [ 5 ], [ 6 ]

A medium-sized or smaller non-itchy rash in a child - in the form of spots or nodules - can be observed with Coxsackievirus infections and ECHO infections in children, as well as with most forms of erythema infectiosum, such as erythema infectiosum of Gianotti-Crosti.[ 7 ]

Experts associate the development of papular acrodermatitis in children with Coxsackie viruses, HHV-6, HHV-5 (cytomegalovirus) and parvovirus B19. In this case, symmetrically located red rashes (consisting of papules and vesicles) appear on the extensor surfaces of the arms and legs, on the forearms and thighs and persist for several weeks; they can merge, but do not cause itching.

Contact (direct or indirect) can cause infection with the poxivirus Molluscus contagiosum. As a result, a type of chronic viral dermatosis called molluscum contagiosum develops, 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, molluscum contagiosum is localized on the eyelid. The rash is white, pinkish or flesh-colored, raised, dense papules (2-5 mm in diameter). [ 8 ]

Less common causes of non-itchy rashes in children include:

• systemic vasculitis (inflammation of the skin vessels) - Behcet's disease in children with rashes in the form of hyperemic nodules; [ 9 ]
• purpura or Henoch-Schonlein disease, which is a hemorrhagic cutaneous vasculitis, affects the capillaries of the skin; symmetrically located hemorrhagic rash affects the extremities (extensor surfaces), back, buttocks, abdomen; [ 10 ]
• juvenile polyarteritis nodosa and dermatopolymyositis; [ 11 ]
• idiopathic granuloma annulare. [ 12 ]

Risk factors

Specialists consider only risk factors for the development of diseases whose symptom is a skin rash that is not accompanied by itching. And such factors are recognized as: prematurity of the child, insufficient hygiene and poor sanitary and living conditions; weakened immune system and 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 division and accumulation of viral RNA begins - reproduction with the release of toxins.

Viruses that cause rashes are classified as 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, expansion of capillaries, and the development of a local inflammatory reaction.

More information in the articles:

• Herpesvirus infections
• What causes systemic vasculitis?
• Henoch-Schonlein Disease Causes and Pathogenesis

Complications and consequences

In case of miliaria crystallineis 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 areas of the skin.

The rash caused by the molluscum contagiosum virus may become itchy and painful, and the skin in the area may become red or swollen.

In children with Behcet's disease, the consequences of the rash may manifest as skin ulcers, and when they heal, the formation of deep scars.

Diagnostics of an itchless baby rash

In addition to anamnesis, physical examination and skin examination, diagnostics include blood tests: general clinical, biochemical, immunological – for specific antibodies (IgM and IgG) to viruses.

It is also imperative to take into account absolutely all symptoms that occur with rashes.

Instrumental diagnostics involves performing dermatoscopy.

Differential diagnosis

Differential diagnosis helps a pediatrician or dermatologist determine the etiology of the rash in order to choose the correct treatment tactics.

Treatment of an itchless baby rash

By the way, in children, a rash without itching often goes away on its own, and treatment, as such, consists of prescribing antipyretic drugs at high temperatures, in particular, from the NSAID group (Ibuprofen, etc.).

This tactic is used by pediatricians for erythema neonatorum, rubella, infectious mononucleosis; infectious erythema of viral etiology; hand-foot-and-mouth disease (usually vitamins B1 and B2 are prescribed); vitamin A may be prescribed for measles.

In cases of prickly heat, the rash can be washed off with a cream containing provitamin B5 - dexpanthenol (Bepanten, Pantestin, D-Panthenol). Herbal treatment also gives a positive result: the child is bathed in water with the addition of a decoction of chamomile, three-part succession, and lovage. And in the development of enterovirus 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% iodine alcohol solution, 5% potassium hydroxide solution, salicylic ointment, 0.05% Tretinoin gel with trans-retinoic acid (which should not be applied to rashes in the eye, mouth and nose area).

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

Also read:

• How to Treat Skin Rash
• Ointments for skin rashes
• Prickly heat in a child: what does it look like, how to treat it at home?
• How is polyarteritis nodosa treated?

Prevention

Prevention of rubella is vaccination; against other viral infections mentioned above, only personal hygiene and quarantine rules 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

The rash without itching in a child goes away, but the general prognosis for the outcome of the underlying disease depends on its etiology and the severity of other symptoms.