Common Skin Rashes in Children

Childhood skin rashes are frequently evaluated by primary care physicians and are often diagnosed by recognition of distinguishing features. Atopic dermatitis affects 15% to 20% of children, usually with onset before the age of 2 years. Treatment is based on severity and begins with emollients and topical steroids. Erythema infectiosum presents with the slapped cheek rash that progresses to reticular lesions on the trunk and extremities. Hand-foot-and-mouth disease presents with painful oral ulcers and vesicular eruption of the hands, feet, buttocks, and genitals. Nonbullous impetigo is characterized by lesions with honey-colored crusting, whereas bullous impetigo presents with flaccid bullae; both are treated with antibiotics. Molluscum contagiosum is characterized by dome-shaped umbilicated papules that spontaneously resolve over months to years without intervention but may be treated with cryotherapy, curettage, or topical agents. Pityriasis rosea usually presents with a large herald patch on the trunk followed by the eruption of numerous smaller lesions aligned with Langer lines. Scarlet fever is a group A beta-hemolytic streptococcal infection with a sandpaper-like rash and should be treated with antibiotics to prevent rheumatic fever. Tinea capitis requires treatment with systemic antifungals, whereas tinea corporis is usually treatable with topical agents.