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Rashes (child care and schools)

A rash involves a change in the color and/or texture of skin and can have many different causes. It can be a symptom of a contagious or non-contagious disease. Contact dermatitis (an inflammation of the skin caused by direct contact with an irritating substance) can occur following an exposure to dyes and chemicals found in clothing, chemicals found in elastic and rubber products, cosmetics, poison ivy, and poison oak. This type of rash usually occurs where the irritating agent touches the skin. Eczema (a chronic hypersensitivity reaction in the skin) can cause a scaly and itchy rash. Medications, foods, or insect bites that cause allergic reactions can also cause a rash. The table below outlines 11 different illnesses that can cause rashes.

Chickenpox (Varicella): Viral

bare back with chickenpox

Appearance: 

  • Blister-like rash that scabs over

Distribution: 

  • More abundant on trunk than extremities

Itching: 

  • Yes

Comments/exclusion: 

  • Highly contagious
  • Immunization is available
  • Exclude until blisters scab over

Fifth disease (Erythema Infectiosum, Human Parvovirus): Viral

 

cheek with signs of fifth disease

Appearance:

  • Red cheeks (“slapped cheek”)
  • Red, lace-like rash on body
  • May fade and then reappear

Distribution:

  • Begins on cheeks, spreads to trunk and extremities

Itching:

  • Slight, if any

Comments/exclusion:

  • No exclusion is necessary for healthy people.
  • Exposed pregnant people should contact their health care provider.

Hand-Foot-Mouth (Entero- and Coxsackieviruses, Viral Exanthem): Viral

hand with hfm rash

 

foot with hfm rash

Appearance:

  • Small blister-like sores

Distribution:

  • Palms, soles of feet, mouth and buttocks

Itching:

  • No

Comments/exclusion:

  • No exclusion is necessary unless the child has mouth sores and is drooling uncontrollably.

Impetigo (Streptococcal and Staphylococcal bacteria): Bacterial

impetigo rash on leg

 

Appearance:

  • Small blisters that burst to reveal red skin, may leak honey-colored fluid

Distribution:

  • Usually the face, arms, or legs but can occur anywhere

Itching:

  • Yes

Comments/exclusion:

  • Exclude at the end of the day until treatment is started. If treatment is started before the next day, no exclusion is needed.

Measles (Rubeola, Hard Measles): Viral

measles rash

Appearance:

  • Red, raised, and flat spots
  • Rash turns white on pressure

Distribution:

  • Begins on face along hairline, spreads to trunk and extremities

Itching:

  • Slight, if any

Comments/exclusion:

  • Highly contagious
  • Immunization is available
  • Exclude for five days after rash onset

Ringworm (Tinea): Fungal

ringworm rashringworm rashringworm rash

Appearance:

  • Small red bump or ring that spreads outward

Distribution:

  • A single area of skin

Itching:

  • Yes

Comments/Exclusion:

  • Exclude from the end of the day until treatment is started.

Rubella (German Measles): Viral

rubella rash

Appearance:

  • Small pink spots
  • May become confluent but remains pink

Distribution:

  • Begins on face, spreads to neck, trunk, and extremities

Itching:

  • No

Comments/exclusion:

  • Immunization is available
  • Exclude for seven days after rash onset

Scarlet Fever (Group A streptococci): Bacterial

Appearance:

  • Small red bumps
  • Rash turns white on pressure
  • Pigmented areas in skin creases

Distribution:

  • Begins on neck and groin, spreads to rest of body 

Itching:

  • No

Comments/exclusion:

  • Strep throat symptoms are present. 
  • Exclude until 12 hours after appropriate antibiotic treatment.

Shingles (Herpes Zoster): Viral

shingles rash

Appearance:

  • Small red bumps or blisters. Rash turns white on pressure
  • Pigmented areas in skin creases

Distribution:

  • Begins on neck and groin, spreads to rest of body

Itching:

  • Yes, and/or painful

Comments/exclusion:

  • No, unless the rash cannot be covered
  • Exclude if meets other exclusion criteria (e.g. fever, unable to participate, etc.).