Dear Doctor,

I travelled upcountry with my children for the festive season. Sadly, they all developed a bad skin rash which left me wondering what could have caused it. Could it be the food, water or something else? Can such irritation be prevented? Marion

Dear Marion,

A rash is a reaction of the skin, commonly due to some infection or irritant or allergy.

Common infections causing skin rashes are viral, bacterial or fungal. Viral infections like molluscum contagiosum, measles, chicken pox, e.t.c. can cause generalized rashes along with eruptions ,which occur in different stages of the disease. Along with rashes, there may be itching. These infections usually subside over a week or so, even without any treatment.. Bacterial infection like streptococcal can cause generalized rashes along with pain with or without fever. Staphylococcal infection causes localized rash or rashes. There can be collection of pus inside resulting in boils. Any rash due to allergy or viral infection can become infected with bacteria and convert into a painful boil. These infections need anti bacterial drugs for cure and untreated may increase in size and number.

Fungal infections cause flat blackish, reddish or whitish flake like rashes, which are mostly itchy. The infecting fungus mostly grows due to dampness. It can be localized or generalized and is absolutely curable by anti fungal drugs. Any of these infection can be diagnosed by the typical onset and nature of rash and simple laboratory tests.

Eczema is a chronic skin condition causing skin to be dry, red, cracked and itchy. Atopic eczema commonly occurs in children and develops behind the knees or on the elbows, neck, eyes and ears. It isn’t a serious condition, but looks ungainly, hence makes parents worry. Eczema or allergic rash can be due to allergy to soap or some other body care product used on the body. Nylon clothes are also implicated in this regard. Erythema multiforme is a mild generalized skin rash which occurs in response to herpes simplex infection or even drugs. Drugs like sulphur group of antibiotics can also cause erythema multiforme due to allergy.

Psoraisis can cause small, scaly, itchy ring like patches in children, which commonly occur on backside of extremities. The exact cause of psoriasis is not known, but it is said to occur due to immune response of the body. The triggering factors are streptococcal, staphylococcal infections, minor cuts or injury, stress, vitamin D. deficiency and genetic factors. This condition occurs intermittently and comes and goes spontaneously.

Cause of skin rash can be known by physical examination, blood tests and scrapings from the skin rash. Treatment depends on the underlying cause.