Understanding the Secondary Rash Following Hand, Foot, and Mouth Disease
Last Monday (July 28), my 4-year-old son woke up with a fever that left him feeling quite miserable, spiking as high as 104.9 degrees. He has a history of high fevers, so this wasn’t entirely unexpected. By Tuesday, he seemed to improve although he still had a low-grade fever. However, by Tuesday night, we observed some spots appearing on his hands and feet. A visit to the pediatrician on Wednesday confirmed our suspicions: he had contracted Hand, Foot, and Mouth Disease (HFMD). His symptoms were classic, featuring spots and blisters on his hands, feet, throat, and a few on his bottom. Our 1-year-old daughter caught a fever that same Wednesday afternoon and began developing spots by Thursday. Fortunately, by Friday evening, everyone was starting to recover, and my son was particularly on the upswing. Then came Saturday, when he developed a separate, concerning rash. It began on his back and neck, quickly spreading to his chest and abdomen as the day progressed. This rash has been incredibly itchy, causing him significant distress, with bouts of discomfort every 30 minutes to an hour. It appears red with tiny, rough bumps resembling chill bumps or chicken skin. Although it’s showing signs of improvement after five days, it still seems to irritate him significantly. He has a background of allergies and asthma, yet we can't pinpoint any triggers or new exposures that might have caused this reaction. The itchiness strikes him at the most random times, irrespective of his activities, clothing, food intake, or whether he’s indoors or outside. He describes the sensation as “small itchies” and points to various areas of his body that feel bothersome. Both our allergist and pediatrician are treating this as post-viral eczema, but I have doubts. We have never encountered a situation like this following a viral infection, especially one that has persisted for so long and has shown little improvement despite our efforts. We've tried almost everything: lotions, colloidal oatmeal baths, oatmeal soaks, baking soda baths, a 2.5% hydrocortisone cream, and even a three-day course of prednisolone. Despite our best efforts, relief remains elusive, and we're starting to feel overwhelmed. Has anyone experienced a similar rash following a viral illness? What can we try next, and will this ever resolve? Any guidance would be greatly appreciated!
Answers (1)
8/6/2025, 5:02:13 PM
OpenHealth AI
It sounds like your son is dealing with a very uncomfortable and distressing situation following his Hand, Foot, and Mouth Disease (HFMD). It’s understandable to feel overwhelmed, especially when treatments haven’t provided sufficient relief. While your healthcare providers suspect post-viral eczema, the characteristics of the rash and the itchiness are understandably concerning, especially since your son has a history of allergies and asthma.
Key Points:
- Post-Viral Eruption is Possible: Following HFMD or any viral illness, it's common for some children to develop a secondary rash or skin irritation. These can sometimes manifest like eczema or hives, especially in kids with a history of atopic conditions.
- Persistent Itching Needs Attention: While it can take time for skin issues post-viral illness to improve, your son's significant discomfort signals that additional steps might be necessary.
Explanation:
The rash you describe—red, itchy, with tiny bumps—might indeed be linked to his previous viral infection, or it could reflect a separate issue triggered by the stress on his body from the illness. The itchiness could be due to irritation, dryness, or an allergic response. Even common treatments can sometimes take a while to help, and what works for one child may not work for another.
Next Steps:
-
Continue Moisturizing: Focus on applying a thick, fragrance-free moisturizer multiple times a day, especially after baths. Consider products with ceramides or specific eczema lotions recommended by dermatologists.
-
Cold Compresses: When itching is severe, apply a cold compress to the affected areas for about 10-15 minutes. This can provide temporary relief from itchiness.
-
Consider Antihistamines: Over-the-counter antihistamines like diphenhydramine (Benadryl) may help reduce itching, especially if taken before bedtime to enhance sleep. However, consult your pediatrician about dosage.
-
Monitor for Triggers: Keep an eye out for potential irritants that may worsen his rash like soaps, detergents, or new materials in clothing. Since he has a history of allergies, a careful review of his environment and products may uncover possible triggers.
-
Consult a Dermatologist: If the rash continues to cause significant discomfort or does not improve, consider scheduling an appointment with a pediatric dermatologist. They can offer specialized insight and alternative treatments, including prescription options such as stronger topical steroids or other medications.
-
Document Symptoms: Keeping a daily log of the rash's appearance, timing, and any changes can provide valuable information for healthcare providers in tailoring the right treatment.
Reassurance:
While it's frustrating and concerning to see your child suffer from ongoing discomfort, many post-viral rashes resolve with time. Through consistent care and often through the right adjustments in treatment, relief is definitely possible. It’s important to stay engaged with your child's health team, and don't hesitate to seek help whenever necessary. Please feel free to reach out for further clarification or support.
Related Questions
Understanding My Symptoms: A Personal Account
I’m sharing my experiences here, as I haven’t received much feedback elsewhere. I am a 15-year-old female, measuring about 5 feet tall (152 cm) and weighing between 105 and 110 pounds (47-50 kg). I identify as Hispanic and Cuban, and legally fall under the white classification. I reside in Palm Beach County, Florida, and I am a U.S. citizen. I have a diagnosis of Autism and previously had ADD, although that diagnosis has been dropped, which leaves me unsure about my current condition—whether ADHD applies or not. Additionally, I have a past history of anemia, although it is currently not diagnosed. For the past year, I've experienced a range of symptoms that appear intermittently and are often present almost daily. While these symptoms vary, they haven’t subsided. I’ve noticed that both physical activity and caffeine can either trigger or exacerbate these issues. Now, I’d like to detail the symptoms I've been facing. One of my major concerns is my balance; when I stand, I often feel unsteady, and sometimes I even limp. This particular symptom is quite troubling as it occurs frequently. I also experience occasional dizziness and fatigue, which leaves me feeling too weak to move, causing me to remain still for prolonged periods. During episodes of significant fatigue or balance issues, I find myself starting to stutter and I suspect my speech may slur at times. Additionally, my hands sometimes shake, especially when I struggle to walk. There could be other symptoms I haven’t recalled yet, but this is what I remember for now. I will provide updates if I think of anything else, and I welcome any engagement. Furthermore, I’ve noticed irregularities with my heart rate. Initially, when these symptoms began, my resting heart rate dropped from the 80s and 90s to the 50s and 60s; this lower rate has persisted. Lately, however, even simple tasks such as standing, walking short distances, or rocking back and forth (which I do as a self-soothing mechanism) have caused my heart rate to spike to the 100s. These changes are new, while the other symptoms have been consistent for about a year. I genuinely seek guidance or support, as I feel uneasy relying on AI for self-assessment. Unfortunately, I can't afford doctor visits at this time, and my caretaker has shown little concern for my well-being. Therefore, please refrain from suggesting medical consultations. Thank you for taking the time to read my story. I’m open to any questions.
What Could This Bump Be? Should I Be Concerned?
I’m a 22-year-old male, standing at 6 feet 2 inches tall and weighing 180 pounds. I currently don’t take any medications and have no significant medical history. Recently, I discovered two small, white bumps on my finger, which appeared around two days ago. They feel firm, much like the sensation of a splinter lodged underneath the skin, and they stick out slightly above the surface. One bump is located at the joint of one finger, while the other is positioned at the tip of another finger on my opposite hand. These bumps are neither painful nor bothersome, but I’m curious to know whether I should consider having them removed or if they might resolve on their own over time. I would appreciate any guidance regarding this matter. Thank you!
Concerns About Rhabdomyolysis?
Background - F34, residing in Texas, USA, is currently trying to get back into shape after a period of inactivity. After an intense workout on Wednesday that included squats and lunges, I pushed myself too hard. Following my strength training, I spent 15 minutes on the elliptical, leaving my legs feeling weak and shaky. Since then, I've experienced difficulty walking, sitting, and even rising from a seated position. Although I have dealt with muscle soreness before, this time feels different and more intense. This morning, I woke up experiencing post-nasal drip and a sore throat, which raises concerns about possibly coming down with a cold or flu. However, I am also aware that rhabdomyolysis can present with flu-like symptoms, making my situation more confusing. By the evening, my condition seemed to worsen, as I began to feel chills, generalized body aches, swollen lymph nodes, a headache, and nausea, though I haven’t actually vomited. While I believe these symptoms correlate with a potential cold or flu, there is significant symptom overlap that makes me uncertain about the level of concern I should have. So far, my urine appears normal—slightly yellow but not the tea-colored hue often associated with rhabdomyolysis. I also conducted a COVID-19 and flu test this evening, and fortunately, the results were negative. I am left wondering at what point I should be alarmed enough to seek medical attention for rhabdomyolysis. As long as my urine remains normal, does that mean I'm in the clear? If it weren’t for the flu-like symptoms, I would feel reassured by the appearance of my urine, but now I’m second-guessing that. Any guidance on what symptoms to monitor for or when it might be appropriate to seek medical evaluation would be greatly appreciated! Thank you!
Is This a Hemorrhoid or Something Different?
Greetings everyone, I'm a 24-year-old male weighing 82 kg, and I’ve noticed a small, pinkish growth at the edge of my anus that appeared last Wednesday. This bump doesn’t seem to be deeply rooted, is only mildly painful, and mainly causes an uncomfortable sensation when I cough or tense the area. Notably, I haven’t observed any pus, significant swelling, or fever accompanying this. Currently, I am on a regimen that includes sertraline, Bifilac (a probiotic), and omeprazole. It's worth mentioning that I had an abscess before—located in my abdominal area—and that experience was quite distressing. Because of this, I find myself feeling anxious and concerned that I might overlook any early indicators this time around. Interestingly, the same day the bump appeared, I also began experiencing nasal congestion and a general sense of fatigue, resembling mild cold or viral symptoms. Do you think this situation aligns more with the characteristics of a hemorrhoid or perhaps a skin tag (papule), rather than an abscess? What typical signs and sensations might accompany early-stage hemorrhoids? I apologize for any discomfort caused by this topic, but I’m not looking for a diagnosis, just some insight into whether this aligns with common issues. Thanks for your help!
Seeking Guidance on Recurring Pilonidal Sinus Issues
I'm a 17-year-old male of Indian descent, standing at 5'8" and weighing 103 kilograms, and I'm dealing with pilonidal sinus problems. My issues began when I noticed blood on the toilet seat; I initially dismissed it as perhaps an anal fissure. However, after four months, I visited a doctor who diagnosed me with a pilonidal sinus. My symptoms included an unpleasant odor and bloody discharge that often stained my clothing. Subsequently, I was placed on a surgical waiting list. By the time my surgery arrived, the situation had worsened significantly, making the procedure even more traumatic and painful than anticipated. The surgeon ended up removing more tissue than originally planned. During my recovery, I inspected the surgical site and discovered a noticeable indentation at the top with various irregular bumps extending down. The doctor assured me that these would eventually fade, but instead, they collected lint and hair over time. Fast forward a year, and I began to notice the same familiar odor again, filling me with anxiety about a potential recurrence. Now, as an 11th grader, I am under pressure to maintain good grades and cannot afford to miss school. Presently, my symptoms include the telltale smell, although I haven’t observed any discharge or developed any additional openings aside from the dimple left from my previous surgery. Before the operation, the infected sinuses extended close to the rectum, which is why I am concerned that a new pilonidal sinus may have formed in the same area. At this moment, I am free from pain but cannot shake the anxiety surrounding the reappearance of the odor associated with this uncomfortable condition.