Viral Skin Infections

Three main groups of viruses cause the majority of viral skin infections, including the following:

Other childhood viral skin infections include the following:

Herpes Zoster (Shingles)

What is herpes zoster?

Herpes zoster, or shingles, is a reactivation of the varicella-zoster virus (chickenpox). The virus causes a painful rash of small blisters on a strip of skin anywhere on the body. On some occasions, the pain may continue for a prolonged period of time even after the rash is gone.

After a person has had chickenpox, the virus lies dormant in the nerves. If the virus reactivates, however, it causes shingles. Herpes zoster is more common in people with depressed immune systems or over the age of 50. It is very rare in children, and the symptoms are mild compared to what an adult may experience.

Children who have weakened immune systems may experience the same, or more severe, symptoms as adults, however.

What are the symptoms of herpes zoster?

Herpes zoster most often occurs on the trunk and buttocks, but can also appear on the arms, legs, or face. Each child may experience the symptoms differently. The most common symptoms may include:

  • Skin hypersensitivity in the area where the herpes zoster appears
  • Mild rash, which appears after five days and first looks like small, red spots that turn into blisters
  • Blisters that turn yellow and dry
  • Rash which usually goes away in one to two weeks
  • Rash localized to one side of the body

The symptoms of herpes zoster may resemble other skin conditions. Always consult a physician for a diagnosis.

How is herpes zoster diagnosed?

Diagnosis usually involves obtaining a medical history of the child and performing a physical examination. Diagnosis may also include:

  • Skin scrapings (gently scraping the blisters to determine if the virus is shingles)
  • Blood tests

What is the treatment for herpes zoster?

Specific treatment for herpes zoster will be determined by a physician based on:

  • The child's age, overall health, and medical history
  • Extent of the condition
  • The child's tolerance for specific medications, procedures, or therapies
  • Expectations for the course of the condition
  • Child or parent’s opinion or preference

Medication may help alleviate some of the pain, but the condition has to run its course. Immediate treatment with antiviral drugs may help lessen some of the symptoms. Use of medication will be determined by a physician based on the age of the child and the severity of the symptoms.

Pityriasis Rosea

What is pityriasis rosea?

Pityriasis rosea is a mild, but common, skin condition that is characterized by scaly, pink, inflamed skin. The condition can last from four to eight weeks but usually leaves no lasting marks.

What causes pityriasis rosea?

The cause of pityriasis rosea is not known, but it is likely caused by a virus. It usually occurs in children, adolescents, and young adults (more than 75 percent of people with the rash are 10 to 35 years of age.) In addition, pityriasis rosea is more common in spring and fall.

What are the symptoms of pityriasis rosea?

Pityriasis rosea usually starts with a pink or tan oval area (sometimes called a herald or mother patch) on the chest or back. The main patch is usually followed (after a few weeks) by smaller pink or tan patches elsewhere on the body, usually the back, neck, arms, and legs. The scaly rash usually lasts between four to eight weeks and will often disappear without treatment.

Each child may experience the symptoms differently. Common symptoms include:

  • Headaches
  • Fatigue
  • Aches
  • Itching

The symptoms of pityriasis rosea may resemble other skin conditions or medical problems. Always consult a physician for a diagnosis.

How is pityriasis rosea diagnosed?

Pityriasis rosea is usually diagnosed with a medical history and physical examination of the child. The rash of pityriasis rosea is unique, and the diagnosis is usually made on the basis of a physical examination. In addition, the child's physician may order the following tests:

  • Blood tests
  • Skin biopsy-the removal of some of the diseased skin for laboratory analysis. The sample of skin is removed after a local anesthetic is administered.

What is the treatment for pityriasis rosea?

Specific treatment for pityriasis rosea will be determined by a physician based on:

  • The child's age, overall health, and medical history
  • Extent of the rash
  • The child's tolerance for specific medications, procedures, or therapies
  • Expectations for the course of the rash
  • Child or parent’s opinion or preference

There is no cure for pityriasis rosea, and the infection usually goes away on its own. The goal of treatment is to relieve symptoms associated with the condition, such as itching. Depending on the severity of the condition, treatment may include one, or more, of the following:

  • Medicated lotions and creams (to soothe the itching)
  • Medications by mouth (to soothe the itching)
  • Cool baths with or without oatmeal (to soothe the itching)
  • Ultraviolet exposure (under a physician's supervision)
  • Cool compresses (to soothe the affected skin)

Warts

What are warts?

Warts are non-cancerous skin growths caused by the papillomavirus. Warts are more common in children than adults, although they can develop at any age.

Warts are contagious, and can spread to other parts of the body or to other people. There are many different types of warts, due to the fact that there are more than 60 types of the papillomavirus. Warts are typically not painful, except when located on the feet, and most warts go away without treatment over an extended period of time.

What are the common types of warts?

The more common types of warts include the following:

  • Common warts are growths around nails and the back of hands; usually have a rough surface; grayish-yellow or brown in color
  • Foot warts are located on the soles of feet (plantar warts) with black dots (clotted blood vessels that once fed them); clusters of plantar warts are called mosaic. These warts may be painful
  • Flat warts are small, smooth growths that grow in groups up to 100 at a time; most often appear on children's faces
  • Genital warts grow on the genitals, are occasionally sexually transmitted; are soft and do not have a rough surface like other common warts.
  • Filiform warts are small, long, narrow growths that usually appear on eyelids, face, or neck.

What is the treatment for warts?

The specific treatment for warts will be determined by a physician based on:

  • The child's age, overall health, and medical history
  • Extent of the growths
  • The child's tolerance for specific medications, procedures, or therapies
  • Expectations for the course of the growths
  • Child or parent’s opinion or preference

Warts in Children often disappear without treatment. Treatment of warts depends on several factors, including:

  • Length of time on the skin
  • Location
  • Type
  • Severity

Treatment for more stubborn or recurring warts may include:

  • Application of salicylic and lactic acid (which softens the infected area)
  • Freezing with liquid nitrogen
  • Electrodesiccation (using an electrical current to destroy the wart)
  • Immunotherapy
  • Laser surgery

Molluscum Contagiosum

What is molluscum contagiosum?

Molluscum contagiosum is a viral disease of the skin that causes small pink- or skin-colored bumps on the skin of a child. It is not harmful and usually does not have any other symptoms. The virus lives inside the bumps and is mildly contagious. The bumps usually clear up without treatment over 6 to 9 months.

What causes molluscum contagiosum?

Molluscum contagiosum is caused by a virus called the poxvirus. It is most common in children and adolescents, although it can also affect adults.

What are the symptoms of molluscum contagiosum?

The bumps are small and are usually pink- or skin-colored. Over time, the bumps may develop a small, sunken center. Children usually develop between two and 20 lesions, often in clusters. They are not harmful, but may cause some cosmetic concern for the child if they appear on the face or other visible areas.

How is molluscum contagiosum diagnosed?

Molluscum contagiosum is usually diagnosed based on a medical history and physical examination of the child. The lesions are unique and usually are diagnosed on physical examination.

What is the treatment for molluscum contagiosum?

Specific treatment for molluscum contagiosum will be determined by the physician based on:

  • The child's age, overall health, and medical history
  • Extent of the condition
  • The child's tolerance for specific medications, procedures, or therapies
  • Expectations for the course of the condition
  • Child or parent’s opinion or preference

In most cases, the lesions will heal without treatment over 6 to 9 months. Additional treatment options may include:

  • Removal of the lesions
  • Use of topical medications (to speed up healing)
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Dermatology

The Division of Dermatology at Children's National Health System continues to expand services as more families seek our expertise in the diagnosis and treatment of disorders of the skin, hair, and nails.

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