1 year old 5 months old Dot has had a high fever for 4 days. According to the doctor’s order, mom gave her fever reducer, cold medicine, etc. Since Dot has had fever before, mom obviously had some experience with it, so she wasn’t as nervous as last time. However, when she woke up this morning, she suddenly found a red rash all over Dot’s body. So, my mom, who was not nervous, dialed my phone and asked me anxiously if Dot had measles, scarlet fever, and other infectious diseases. After hearing her story, the first question I asked her was whether she still had a fever. Due to the mother’s panic, she had not yet taken the baby’s temperature. I asked her to come back to the phone after taking the baby’s temperature. Ten minutes later, Dot’s mother called. Dot’s temperature had dropped to 37.2℃. After listening to her, I told her: Don’t be anxious, Dot’s illness has improved. After hearing my answer, the mother was a little confused. As a pediatrician, I knew that she would like to hear this answer, but I could sense her confusion in her tone of voice. Tell Dot’s mom about emergency rash. Emergency rash is a respiratory illness caused by a virus. The initial stage of the disease is the same as a common viral cold, with symptoms such as fever, runny nose and cough. Generally, after 3 to 4 days of fever, a small rash of rice-like red skin suddenly appears all over the body, and some parts of the body may fuse into small patches. The appearance of the rash is accompanied by a significant drop in body temperature. This is why it is medically known as “fever withdrawal rash”, which is a unique clinical feature of this disease. The appearance of the rash rarely causes other troubles for the child. After the rash disappears in 3 to 4 days, the infection is over. Since there are no specific signs and symptoms at the beginning of the onset of the rash in young children, it is difficult for doctors to give an early diagnosis. The diagnosis is not confirmed until the rash appears. In general, treatment can be stopped or supplemented with cough suppressant and phlegm treatment when the rash appears. In fact, the process of treating an emergency rash in young children is basically the same as that of a viral respiratory infection. Therefore, the diagnosis of “hindsight” does not affect the treatment of the disease. Emergency rash in young children is a relatively specific febrile rash. It often affects children aged 6 months to 3 years. There are other types of febrile rashes. Most children with febrile rashes usually recover with symptomatic treatment and do not persist or have any sequelae. However, a small number of children may have encephalitis or meningitis caused by the spread of viruses or bacteria to the central nervous system or complicated by ear or lung infections. Therefore, when parents observe changes in their children’s body temperature and rash, they should pay special attention to the presence of serious signs such as abnormal drowsiness, refusal to drink, earache, shortness of breath, difficulty breathing and severe headache. If any of these signs appear, seek medical help immediately. Postscript: Three days later, the mother called to tell me happily that Dot had recovered. Rashes associated with fever Children can easily develop rashes, which can have more than 10 different causes. The most common ones are eczema, ringworm, and seborrheic dermatitis. These are dermatological disorders and can be treated at the time of choice. However, rashes associated with fever are diseases that require urgent medical attention and are often caused by viral or bacterial infections, mostly acute respiratory infections. Early diagnosis and treatment and proper isolation can protect children and reduce the risk of infection in the surrounding population. Chickenpox There are often small epidemics of this disease in kindergartens and schools. An itchy rash with blister formation should be considered chickenpox. Chickenpox is a respiratory infection caused by the varicella zoster virus that spreads easily among groups of children. Chickenpox is characterized by the simultaneous presence of three phases of the rash: a new small red spot, blisters and crusts. When all the blisters have crusted over, the disease is not transmitted to others. Scarlet fever A feverish child has a uniform rash of small rice-like patches of skin over the body. When the skin is lightly scratched with a fingernail, visible red and swollen scratches are seen, which doctors call positive skin scratches. The child’s tongue is also red and swollen with a rough surface, which is medically described as a strawberry tongue. Rubella Usually presents as a rash of light red spots. Swollen lymph nodes that are palpable behind the ears, behind the occiput and on the neck of the child are likely to have rubella. Measles The rash is preceded by prodromal symptoms of runny nose, cough, and red eyes; when the rash appears, the child usually has a high temperature and the rash appears as flat, dark red patches or patches. Tip: Although there is a vaccine to prevent measles in routine pediatric vaccinations, there is still a possibility of getting measles again several years after vaccination. When a child who has been vaccinated against measles develops a rash, it is likely that the rash will not have the characteristics described above, which is known as an atypical rash. Some children have taken chemical drugs such as antibiotics and antipyretics before the rash developed, such as acute upper respiratory infections, so it is important to be alert to allergic reactions caused by the drugs themselves. It is not uncommon for fever to be accompanied by a rash in pediatric illnesses. However, even if you know more about such diseases, your doctor should help you to finalize the diagnosis and guide the treatment. During the treatment process, you should also closely monitor for the appearance of any serious signs.