The Viral Rash – Exanthem

shutterstock_137048072A rash caused from a virus that is widespread and usually occurring in children is called a exanthem.  The first four listed below are the “classic” childhood viral rashes, but we recognize others that can also cause virus, some of those are also listed below (see 5-7):

1)   Rubeola is also known as the measles and is caused from the measles virus and produces reddish macules and papules behind the ears and at the anterior hairline, coalescing and spreading over the neck and trunk and finally affecting the arms/hands and legs/feet.

2)   Rubella is also known as German measles and is caused by the togavirus.  The eruption presents with pink-red macules and papules on the face and spreads down the body over 24 hours.  The rash begins to fade after 1-2 days in the order of appearance and disappears completely in 2-3 days.

3)   Erythema infectiosum is caused by parvovirus B19 and has confluent reddish and swollen patches on the cheeks, with sparing of the bridge of the nose and areas around the eyes.  These so-called slapped cheeks fade over 1-4 days.  The rash may spread to the trunk, arms and legs and may change to look like a lacy reticular pattern.  This rash may be itchy.

4)   Roseola infantum is caused by HHV-6 and HHV-7 and has non-itchy, rose-pink 2-3mm discrete macules and papules that blanch on pressure and are surrounded by white halos.  The eruption is usually first seen on the trunk and then spreads to the arms and legs.

5)   Chicken pox or shingles is caused by the Varicella zoster virus

6)   Mumps is caused by the mumps virus

7)   Rhinovirus which also causes the common cold can cause rash

8)   Hand-foot-mouth disease caused by Coxsackie virus can cause painful ulcers in the mouth, and the rash in the mouth begins as 2-8mm reddish macules and papules that progress through a short vesicular stage to form a yellow-grey ulcer with a reddish halo. Oral lesions usually resolve in 5-7 days.  The skin rash is characterized by 2-3mm reddish macules or papules with a central gray vesicle that usually appear shortly after oral lesions.  The hands are more commonly involved than the feet.

Immunizations have decreased the numbers of measles, mumps and rubella but we still see these infections in the medical clinic.

Description:  Usually pink or red rash without a typical pattern. It may have red spots that are slightly raised.  It usually isn’t very itchy. They may be faint pink or more extensive, and usually blanches (goes white) with pressure.  If you place a drinking glass against the rash, you may see it disappear through the glass.

Some other symptoms that may be present along with a viral rash include low-grade fever, headache, sore throat, malaise, nausea, diarrhea or joint pain.

Treatment:  There is no treatment for a viral rash.  The rash will disappear as the body recovers from the infection.

When to get medical help:

1)   The rash does not blanch with pressure

2)   The rash is extremely itchy

3)   The patient is very sick or you are concerned about a serious illness

This document is for informational purposes only, and should not be considered medical advice for any individual patient.  If you have questions please contact your medical provider.


I hope that you have found this information useful.  Wishing you the best of health,

Scott Rennie, DO



3 thoughts on “The Viral Rash – Exanthem

  1. becca

    Hello I woke up monday with a lump on the right side of my face under my jaw but then it got a whole lot bigger, I went to the doctors but they said they don’t know what it is. Then wednesday I got another lump on the left side of my face and my face is really swollen. Then thursday night I came out in a itchy rash all over my stomach, back, inside of my arms and all over my hands. I think its contagious because my boyfriend is now the same but has no rash. Do you know what it is?

    1. Dr. Scott Rennie

      Hi Becca, I think you should talk with your medical provider. It’s hard to tell what this is without seeing it.

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