Paediatrics: Papular rashes (2)

Papular rashes (2)

Papular urticaria

Hypersensitivity reaction to insect bites. Itchy small red papules or vesicles evolve into 1–5mm papules +/– surrounding urticaria or surface crusting. Usually on limbs and buttocks. May last for weeks and be exacerbated by new bites elsewhere. Secondary infection common.

Treatment

•   Prevent new bites.

•   Antipruritics (e.g. oral antihistamines, topical steroids).

•   Antibiotics for any s infection.

Keratosis pilaris

Common. Any age. Horny plugging of follicles causes asymptomatic rough papular rash +/– erythema. Affects upper outer arms, front of thighs, cheeks.

Treatment 

Reassurance; emollients, especially urea-based creams.

Papular acrodermatitis (Gianotti–Crosti syndrome)

•   Acute, non-itchy, red papules appear over face, limbs, and buttocks.

•   Asymptomatic or accompanied by malaise, hepatomegaly, lymphadenopathy.

Causes

•   Enteroviruses.

•   EBV.

•   Adenovirus.

•   Mycoplasma.

Treatment 

Reassurance.

Prognosis 

Spontaneously resolves after a few weeks.