Viral Skin Rashes in Babies
Hi. I'm Dr. David Hill, and today we're going to be talking about viral skin rashes in babies. Now, there are lots of viral skin rashes in babies, but a couple of the ones that you're most likely to see are really very classic and they're worth talking about. One is actually a herpes rash. Now, I want to back up and say that herpes in babies is almost never sexually transmitted. It can be transmitted in arrival through the birth canal and that can happen in women who do not know that they have herpes, in fact about 70 percent of women who transmit herpes are unaware that they ever had an infection in the first place. It can come off a caretakers lips, contact with lips then hands, so there a lot of ways to transmit this. Now, in a newborn, a herpes infection is very dangerous, quite life threatening, so if you see little vesicles, they are like tiny little blisters, on a red base, clustered in one area on a newborn, you want to bring that to the doctor's attention immediately. That can be very dangerous. After the first couple months of life, however, you may still see some lesions around the mouth. This is particularly common in toddlers, kids who are about a year old to two years old where they'll get horrible lesions on the inside of their mouth and then some on the outside. They may form sort of a yellowish crust on them as well. That can really interfere with eating and drinking and should be brought to a doctor's attention if you see it. Now, another viral skin rash that's very common in babies, and again, even more common in toddlers is hand-foot-and-mouth disease. This, like herpes, occurs in the mouth with nasty sores that are terribly painful but the hallmark of this rash is little water blisters that you'll see on the fingertips or on the palms, and then on the soles of the feet. There may also be some little red bumps on other parts of the body, but you'll usually see a fever at the beginning of this. The rash will spread, it will involve the mouth. Babies are unbelievably cranky when they get this and the critical thing is keeping them drinking. Again, you may need your doctors help to find some medications that let your baby get through this without getting dehydrated. Now, a very common group of viral rashes in babies are those that we call the viral exanthems and they're caused really by too many viruses to name. But what we see at the beginning is a fever, usually one or two days in fever. The fever may be relatively high and lemme stop here. If your newborn has a fever, first three months of life, that's an emergency. Never assume that's a virus. The doctor has got to look at that child. After the first three months of life, any unexplained fever still deserves a doctor's examination and consideration, sometimes a urine sample, sometimes you see something at exam that helps you out, sometimes you want to get other labs, chest x-rays, but some of these fevers are going to be viral, in fact, a lot of them will and often, about the day the fever breaks, usually two or three days after it starts, suddenly, there's little red dots everywhere. They tend to start on the trunk and spread outward. They don't usually itch, they may be a little bit raised, they usually blanch if you touch them and they may be there for a week or two before they go away, that's a classic viral exanthem in a newborn and it's absolutely nothing to worry about. What do you worry about? I don't like any rash that when I mash on the skin, the redness doesn't go away for at least a second or two, those rashes are very worse and should always be brought to a doctor's attention. Talking about viral rashes in babies, I'm Dr. David Hill.