In modern medicine, there are many new, mysterious terms for parents. Exanthema is an obscure word that often leads to panic and fear. However, this is not an isolated disease; several conditions are hidden behind it. Most of them are quite harmless and often resolve on their own.
What is exanthema?
Any rash that occurs on the skin is called exanthema. That is, any spots, blisters, blisters of various shapes and quantities - this is exanthema. It can affect people of any age.
Exanthema in children - skin rashes that appear with various diseases. It can be infectious and non-infectious. In babies, viral exanthema is not uncommon, that is, the rash will be a manifestation of a viral infection. Less commonly, a rash is provoked by bacteria, allergic reactions, diseases of the blood and blood vessels. Sudden exanthema is the most common of the viral exanthema.
Pathogens of viral exanthema with saliva particles are transmitted through the air, household items, handshakes, and also through polluted water.
If the rash appears on the mucous membranes - in the mouth, on the eyes, on the mucous membranes of the genitals, then it is called enanthema. Very often, exanthema and enanthema are combined with each other.
Why does exanthema appear?
The mechanism of the appearance of exanthema, of course, depends on the cause that causes it. But there are also general reactions of the body.
When a certain virus or allergen enters the body, the immune system is activated. Her cells are trying to neutralize a foreign agent. A rash appears as a result of complex interactions. A virus or allergen can act directly on the skin, affecting its elements.
In case of bacterial infection, toxins that are produced by the bacterial cell also play an important role in the development of exanthema. They act on cells of the immune system, skin, blood vessels.
In case of blood diseases, viral and bacterial infections, blood cells will be destroyed in small vessels of the skin, causing their blockage. The walls of the capillaries become brittle and brittle, easily damaged. As a result, rashes will appear on the skin.
What diseases is exanthema typical for?
At the beginning of the twentieth century, it was customary for the medical community to designate children's exanthema with numbers. The "first" and "second" diseases were considered scarlet fever and measles. Rubella was called the "third" disease. Infectious mononucleosis, or "fourth" disease, was identified somewhat later. The "fifth" disease is infectious erythema caused by parvovirus B 19. The "sixth" disease, or roseola, completes the list.
The list of viruses capable of causing a reaction in the form of an exanthema goes on. This includes herpes viruses, enteroviruses, ECHO viruses and many others. It can be provoked even by harmless rhinoviruses - the most common causative agents of ARVI.
Of the bacterial diseases occurring with exanthema, the most significant is meningococcal infection, which can even take a baby's life. The well-known scarlet fever can heal on its own, but it is terrible with complications on the kidneys and joints.
Of the non-infectious exanthema, allergic skin reactions are common, in particular to drugs. Vasculitis, or vascular inflammation, occurs in response to an allergic reaction, the action of infectious agents, or cells of your own immune system. The disease is accompanied by a characteristic exanthema.
Clinical picture
The changes that parents will see on the skin of their baby will depend on the causative agent of the infection, if the cause of the exanthema is in it. Plus, the rashes will add symptoms characteristic of a viral or bacterial infection.
Exanthema for allergies or vascular diseases also has its own specific features. Diseases have their own symptoms, different from infections.
Scarlet fever
Scarlet fever is a bacterial infection that causes group A beta-hemolytic streptococcus. These bacteria initially affect the mucous membranes of the pharynx. The child falls ill with sore throat or pharyngitis. Later, they secrete a toxin that enters the capillaries of the skin through the blood vessels, causing exanthema.
A scarlet fever rash looks like bright red small dots that rise slightly above the skin. She, in turn, also becomes red. The largest accumulations of rashes can be seen in the elbow, axillary, and inguinal folds. But the area of the nasolabial triangle remains unchanged with scarlet fever: the skin does not redden there, a rash does not form. Some time after the disappearance of the rash, the child develops peeling on the hands and feet.
Exanthema with scarlet fever is combined with a deterioration in well-being, sore throat, an increase in lymph nodes. Timely prescription of an antibiotic can prevent dangerous complications in the kidneys, joints, heart.
Measles
It is an acute, highly contagious viral infection. The onset of measles is similar to any respiratory viral illness. The child's temperature rises, malaise appears. Dry cough, runny nose, pain when swallowing, conjunctivitis and photophobia are also characteristic.
But on the third or fourth day of the illness, the child's face becomes covered with rashes that look like small spots and red bumps. Around this time, it sinks lower - on the area of the trunk and limbs.
But the exanthema covering the face begins to gradually fade, leaving behind foci of accumulation of pigment. The state of health of a baby carrying measles begins to return to normal when the last elements of exanthema that have appeared on the legs turn pale.
Rubella
The second name for rubella is “three-day measles,” because the disease proceeds like measles, but easier and faster.
Rubella exanthema is similar to measles. The disease is usually milder than measles. The baby may have a slight increase in temperature, a sore throat, and a runny nose.
The main hallmark of rubella is the enlargement of the occipital and other groups of lymph nodes.
Infectious mononucleosis
Infectious mononucleosis is caused by human herpes viruses: Epstein-Barr, or cytomegalovirus. Symptoms of the disease resemble angina: malaise, fever, sore throat, plaque on the tonsils, swollen local lymph nodes, abdominal pain.
An enlarged liver and spleen are the hallmarks of infection. Exanthema does not appear in all children. It has a maculopapular character, it can resemble an allergic rash.
Babies with infectious mononucleosis should not take penicillin antibiotics and cephalosporins, since in 80% of cases they provoke a specific rash. This is the so-called toxic-allergic reaction.
Infectious erythema
Infectious erythema, or "fifth" disease, is an infection caused by parvovirus B 19. Specific exanthema in case of infection may appear on days 2 - 3 of a mild illness resembling a respiratory viral infection. Soreness in the joints is possible. The older the child, the stronger it is.
Rashes with parvovirus infection are specific. The child's cheeks turn red - this is the so-called erythema of "splashed cheeks". Possible exanthema on the trunk and extremities as "socks" and "gloves". The rash takes on the character of lace, mesh. When pressed, it turns pale.
The exanthema disappears in 2 - 3 weeks, but relapses are also possible, lasting up to 3 months, especially with increased physical activity, an increase in temperature, when blood flow in the vessels increases.
Sudden exanthema in children
This infection is also called roseola. It has been diagnosed by pediatricians for over 100 years. Most often it is carried by children from 6 months to 3 years. The appearance of exanthema is preceded by a high fever without cough and runny nose. Redness of the throat is also not observed.
Despite the high numbers on the thermometer, the baby remains active and behaves as if nothing had happened. The appetite is not broken. After 3 - 5 days, the temperature returns to normal, but after a day exanthema appears, resembling an allergy. It disappears without a trace within a week.
It is customary for pediatricians to prescribe antibiotic therapy after 3 to 5 days if the fever does not decrease. This often coincides with the appearance of exanthema, which in roseola can be mistaken for an allergic reaction to an antibiotic.
Papular acrodermatitis
This disease is also called Gianotto-Crosty syndrome. It is caused by many respiratory viruses.
Often the appearance of exanthema is preceded by respiratory infections. An allergic-like rash appears on the extensor sides of the forearms, hips, and other parts of the body. The trunk is not affected. Exanthema lasts up to 8 weeks and is often mistakenly treated as an allergic reaction.
Laterothoracic exanthema
It is a viral self-limiting infection in children. Its causative agent has not yet been identified. Girls are more often sick.
The disease begins with symptoms of a banal respiratory infection or rotavirus infection. In the period of convalescence, exanthema appears.
It looks like spots or bumps up to 1 cm in size and is located on the lateral surface of the body or in the armpit. The other side of the body remains clean. The rash resolves on its own. Complications are not known.
Sometimes exanthema persists for up to 8 weeks and is mistaken for an allergy.
Enterovirus exanthema
Enterovirus exanthema is also called hand-foot-mouth disease due to the typical localization of the rash.
You can get an enterovirus infection all year round, during the summer heat and before the first cold weather there are many times more such children than in winter. The virus is widespread, but it is very common in warm regions, where there are many resorts.
A child who carries an enterovirus infection is worried about pain when swallowing, a rise in temperature to 39 degrees. It lasts up to four days, then subsides on its own. Exanthema appears in the form of bubbles near the lips, palms and soles, and other parts of the body are affected. It can be abundant, but more often from 3 to 5 elements appear on each site. Vesicles can easily suppurate and turn into streptoderma.
The mucous membranes of the mouth are also prone to rashes, which cause pain when swallowing and trying to chew food. There they are stored for up to six days.
Exanthema for allergies
The allergic nature of exanthema can be suspected if there are no signs of infection and there has been contact with something that could cause an allergy. It looks like blisters that rise above the skin, and is accompanied by itching.
It often happens that allergic rashes appear against the background of a viral infection, or taking a drug. This is the so-called toxic-allergic reaction.
Exanthema for vascular diseases
With diseases such as hemorrhagic vasculitis, Kawasaki disease, rashes also appear. They look like bruises or small papules or blisters. Itching does not happen. General weakness or fever, changes in blood and urine tests, and clotting disorders may appear.
Meningococcal meningitis
This is perhaps the most formidable disease in which rashes appear. Therefore, if you suspect meningitis, you need to urgently hospitalize the baby. In this case, you cannot hesitate even a minute, since less than a day can pass from the moment the rash appears until the death of the child.
Meningitis can begin as a banal respiratory infection, but after a few hours a rash appears in the form of bruises. The child's health deteriorates sharply, vomiting appears, he ceases to respond to others, convulsions may begin.
Treatment of exanthema
Viral exanthema pass on its own, it only takes time for the rash to completely disappear. You can only treat the accompanying symptoms: reduce fever, drink a lot, relieve nasal breathing and sore throat.
Bacterial exanthema require antibiotic prescription. In case of meningococcal infection, it should be prescribed immediately after the baby has been examined by a doctor. Treatment of meningococcal infection should be carried out only in a hospital setting, the child may have to be in intensive care for some time.
With timely treatment, the chances of salvation are 80 - 90%. Vaccinations against meningococcal infection have been developed. Unfortunately, vaccination is not part of the national immunization schedule, but the vaccine is available in pharmacies.
With scarlet fever, an antibiotic is needed to prevent formidable complications on the kidneys, joints, and heart.
Allergic exanthema is treated with a special diet, antihistamines. Topically, you can use creams and ointments that reduce itching. It is imperative to identify the cause of the allergic reaction.
In case of vascular diseases, it is important to prescribe drugs that normalize blood coagulation, as well as drugs that act on the immune system. This will avoid serious complications on the internal organs.
Conclusion
Most often, the cause of exanthema is a variety of viral infections, which the body can easily deal with itself. It is important for parents to know their symptoms and not to panic when a rash appears. You should also not associate any rash with allergies.
This leads to unnecessary medications and expensive tests. But if with the appearance of exanthema the child's condition has deteriorated sharply, you should immediately consult a doctor in order to avoid the most negative consequences.
