A case of progressive joint pain and rash in a 5-year-old (2023)

A 5-year-old nonverbal boy with autism spectrum disorder and global developmental delay presented to the emergency department with bilateral lower-extremity bruising and progressive difficulty ambulating. What's the diagnosis?

The case

A 5-year-old nonverbal boy with autism spectrum disorder and global developmental delay presented to the emergency department with bilateral lower-extremity bruising and progressive difficulty ambulating.

One month prior, he began limping, and his mother noticed a new bruise on his right heel. Two weeks later, he presented to orthopedics after developing bilateral ankle swelling and a new bruise on his left ankle. A radiograph of his left leg did not show any osseous abnormalities. Over the next several days, his symptoms progressively worsened, and he was no longer able to walk. His mother reported that he appeared in pain, except when lying in a froglike position. During this time, his mother also noticed swelling in his knees, fine bumps overlying his hair follicles, and bruising on his left calf.

Presentation

A review of his symptoms included profound fatigue and “not acting like himself.” His mother denied trauma, recent travel, or other illnesses in the past month and said he did not take any medications or supplements. She reported that his aversion to certain textures and tastes led to a very poor diet, consisting of cheese crackers, corn chips, toaster pastries, pepperoni, chocolate bars, and sandwich cookies. He was no longer eating chicken nuggets, which were a staple of his diet until the past couple of months. His mother also reported that he unintentionally lost approximately 10 pounds over the past month. She denied that he had fever, mouth sores, gum bleeding, shortness of breath, rhinorrhea, emesis, blood or mucus in his stool, and abdominal pain.

Hospital course

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At time of admission, the patient was noted to have petechiae, ecchymosis, and a perifollicular rash, as well as joint pain with passive range of motion—specifically, internal rotation of his hips and extension of his knees. He had tenderness to palpation of his paraspinal muscles, most significant in his lumbar region. He did not have any appreciable joint swelling. Pain prevented him from walking. Initial laboratory findings included microcytic anemia (hemoglobin, 10.7 g/dL; mean corpuscular volume, 72.6 fL), elevated erythrocyte sedimentation rate (45 mm/h), elevated C-reactive protein (3.26 mg/ dL), and elevated uric acid (7.6 mg/ dL). Results were in the normal range for platelet count (421 K/mm3), white blood cell (WBC) count (8.94 K/ mm3), liver function (aspartate aminotransferase, 24 U/L; alanine aminotransferase, 9 U/L; total bilirubin, 0.2 mg/dL), lactate dehydrogenase (LDH; 269 U/L), and prothrombin time (15 s)/activated partial thromboplastin time (28.3 s).

Rheumatology, dermatology, and hematology/oncology were consult- ed for further evaluation of the boy’s anemia and petechial rash. An MRI of his abdomen, pelvis, and lumbar spine was obtained to evaluate for abdominal mass, subclinical joint effusions, and another osseous source of pain and inflammation. The MRI showed abnormal enhancement of the costochondral junctions, left ischium adjacent to the triradiate cartilage, lumbar spinal processes, lumbar paraspinal musculature, and synovitis in the hips, with small hip effusions concerning for autoimmune process, vitamin deficiency, or postinfectious phenomenon. There was no infiltrative marrow disease or appreciable intra-abdominal mass.

Blood cell counts, including WBC, hemoglobin, and platelets, were normal. Pathology evaluated his peripheral smear and did not find any abnormal cell lines. The patient was noted to initially have an elevated uric acid that normalized with hydration. His LDH and total bilirubin level were normal, making hemolysis unlikely. He was noted to have a low iron level and decreased percentage of total iron-binding capacity saturation, consistent with iron deficiency anemia. Ferritin was normal and not depressed, as would be expected in iron deficiency anemia, likely due to its role as an acute phase reactant.

Given the patient’s limited dietary intake and MRI findings concerning for a vitamin deficiency, his laboratory evaluation was expanded. Serum levels of zinc (65.4 μg/dL) and lead (< 2 mcg/dL) were normal. Vitamin A (0.12 mg/L; reference range [ref], 0.2-0.5 mg/L), vitamin C (< 0.09 mg/ dL; ref, 0.4-2 mg/dL), and vitamin D (25-hydroxy, 11.5 ng/mL) were low.

Dermatology was also consulted for further evaluation of perifollicular rash. On close observation using a dermatoscope, the team noted perifollicular hemorrhages with corkscrew hairs.

Differential diagnosis

The differential diagnosis was initially broad and can be seen in Table 1. The differential included leukemia, an abdominal mass such as neuroblastoma, transient synovitis, septic arthritis, juvenile idiopathic arthritis (JIA), myositis, Henoch-Schönlein purpura, and nutritional deficiencies. His WBC, platelet counts, and peripheral smear were reassuring and did not support leukemia as a likely diagnosis. Imaging demonstrated synovitis, which could be consistent with JIA, transient synovitis, and nutritional deficiencies, but his dermatologic findings were not consistent with JIA or transient synovitis.

The patient’s clinical findings of arthralgia, hip synovitis, and rash showing perifollicular hemorrhages with corkscrew hairs was most consistent with vitamin C deficiency, also known as scurvy.

Scurvy/vitamin C deficiency

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Vitamin C deficiency results from a lack of dietary intake of ascorbic acid, the bioavailable form of the nutrient. Foods high in vitamin C include many fruits and vegetables, including citrus fruits, mango, papaya, kiwifruit, tomatoes, spinach, broccoli, potatoes, and brussels sprouts. The highest vitamin C concentration occurs in the raw food source.1 The nutrient plays an integral role in collagen synthesis. Ascorbic acid assists in the triple-helix formation of collagen, which provides structure for blood vessels, ligaments, cartilage, bone, and skin, and aids wound repair.1 The body can be depleted of vitamin C stores in approximately 1 to 3 months with limited intake or poor absorption from the gut. Due to vitamin C’s effects on collagen formation, as the body becomes depleted, vessel structure weakens and risk of bleeding increases.2

Historically, vitamin C deficiency was associated with situations in which people had limited or no access to a steady dietary intake of fresh fruits and vegetables. The primary example has been sailors on extended voyages, but widespread deficiency has also been associated with major famines and wars that disrupted food supplies.3 More recently, vitamin C deficiency has been associated with children and adults who have limited dietary intake or poor absorption.1

Presenting symptoms

Signs of vitamin C deficiency are often multisystem, including musculoskeletal, dermatologic, and hematologic symptoms, which are initially nonspecific and gradually worsen. Increased fatigue and changes in mood are usually among the first symptoms to arise. Additional symptoms include anorexia, joint pain, joint swelling, perifollicular rash, softening of previous scars, poor wound healing, gingival swelling, and gingival bleeding.3 Because of the joint pain and/or swelling, some patients are thought to have a rheumatologic process, such as JIA, at presentation. Vasculitis may be on the differential because the perifollicular hemorrhages are misinterpreted as a purpuric rash. Malignancy is also typically on the differential due to presentation of anemia, joint complaints, and petechiae.

Laboratory findings

Because laboratory findings are not necessarily reliable, diagnosis is typically based on clinical suspicion. The most available test, the serum ascorbic acid level, is diagnostic if the result is less than 0.2 mg/ dL. However, recent dietary consumption of vitamin C would alter the serum level to falsely normal level. Leukocyte ascorbic acid assay offers an alternative measurement but is not routinely available. The leukocyte assay involves a mixed cell population and provides a more consistent evaluation for total body stores of vitamin C.4

Approximately 75% of patients who are vitamin C deficient are noted to have a normocytic anemia, but they also can have a microcytic or macrocytic anemia, depending on associated deficiencies.2 Additional nutritional deficiencies are common and should be evaluated for, including thiamine (B1), pyridoxine (B6), folic acid, cobalamin (B12), and vitamin D.5

Lastly, due to concern for a potential autoimmune or infectious cause of symptoms, inflammatory markers are often obtained. In vitamin C deficiency, these markers are often elevated; however, the exact mechanism for the elevation remains unclear.2

Musculoskeletal findings

(Video) Joint Pain

Approximately 80% of patients with vitamin C deficiency present with musculoskeletal complaints, which tend to be more prominent in pediatric patients, who can present with severe myalgias. Children may experience significant thigh pain, leading them to sit in a froglike position, legs flexed and externally rotated.6 Typically, patients will endorse arthralgia in the wrists, knees, and/or ankles and can develop hemarthrosis, often involving either the hips, knees, or ankles. The hemarthrosis is thought to be multifactorial and caused by damage to the synovial vessels and microfractures. Lastly, at the distal ends of the diaphysis, subperiosteal hematomas may be palpable.

Radiographic findings are typically found in the distal end of the long bones. General findings will include osteopenia and loss of trabecular bone matrix. More specific findings, which typically arise later and are not present at disease onset, include the white line of Frankel, Trümmerfeld zone “beaks,” and Wimberger ring zone.6 The white line of Frankel is an irregular and thickened white line at the metaphysis. The Trümmerfeld zone (trümmerfeld is German for “field of rubble”) is superior to the white line of Frankel and is a zone of rarefaction in the metaphysis; healing fractures called beaks may be seen along its periphery. The Wimberger ring sign is a white line around the epiphysis. MRI findings are consistent with radiographic findings, but para-epiphyseal subperiosteal hemorrhages may be more apparent. In addition, MRI imaging may show multifocal symmetrical signal abnormalities within the metaphysis.6

Dermatologic findings

Dermatologic findings associated with vitamin C deficiency aid clinical diagnosis. Clinical findings include gingival bleeding, corkscrew hairs, hyperkeratosis, perifollicular hemorrhages, and ecchymosis.7 Vitamin C is important in the formation of disulfide bonds during formation of hair. Without vitamin C, there is increased disulfide cross-linking of the keratin, leading to abnormal coiling of hair and appearance of corkscrew hairs. In addition, the skin is noted to have a rough texture due to hyperkeratosis. If obtained, a skin biopsy will demonstrate follicular plugging with soft keratin. Because of increased hydrostatic pressure stress at the follicle site, there can also be a petechial rash in a perifollicular distribution, which tends to be more pronounced on the lower extremities.3 Occasionally, the perifollicular rash coalesces and develops a raised appearance concerning for purpura. Besides a perifollicular rash, there can be ecchymosis due to the fragile capillaries leading to bleeds.1 Lastly, because of defective collagen production, previous wounds may soften and new wounds may heal poorly.3

Treatment/management

Treatment of vitamin C deficiency includes vitamin C supplementation. For children, the recommended dose is 100 to 300 mg/day for a month. Within a few days, there is typically symptomatic improvement in fatigue, pain, and appetite. Within a couple of weeks, the perifollicular hemorrhages and hyperkeratosis resolve. In about 4 weeks, changes in the hair can be appreciated, with resolution of the corkscrew appearance.

In addition, making sure the child consumes a diet rich in vitamin C through the intake of fresh fruits and vegetables is important. If the child has a restrictive diet, considering supplemental vitamin C may be prudent.

Patient course

The patient was started on supple- mental vitamins C, D, E, K, and A and thiamine, as well as a multivitamin. Within a few days of supplementation, he was noted to have significant improvement in arthralgia. To provide the necessary supplemental nutrition, a gastronomy tube was placed prior to discharge. After discharge, the boy’s speech therapy was increased to 3 times a week with significant improvement in his oral intake.

(Video) Pudhuvai TelePedicon 2020 - Arthritis in children - demystified - Dr. Satishkumar

References

1. Olmedo JM, Yiannias JA, Windgassen EB, Gornet MK. Scurvy: a disease almost forgotten. Int J Dermatol. 2006;45(8):909-913. doi:10.1111/j.1365-4632.2006.02844.x

2. Mertens MT, Gertner E. Rheumatic manifestations of scurvy: a report of three recent cases in a major urban center and a review. Semin Arthritis Rheum. 2011;41(2):286-290. doi:10.1016/j. semarthrit.2010.10.005

3. Hirschmann JV, Raugi GJ. Adult scurvy. J Am Acad Dermatol. 1999;41(6):895-910. doi:10.1016/ s0190-9622(99)70244-6

4. Jacob RA. Assessment of human vitamin C status. J Nutr. 11 1990;120(suppl 11):1480-1485. doi:10.1093/ jn/120.suppl_11.1480

5. Callus CA, Vella S, Ferry P. Scurvy is back. Nutr Metab Insights. 2018;11:1178638818809097. doi:10.1177/1178638818809097

6. Fain O. Musculoskeletal manifestations of scurvy. Joint Bone Spine. 2005;72(2):124-128. doi:10.1016/j. jbspin.2004.01.007

7. Fossitt DD, Kowalski TJ. Classic skin findings of scurvy. Mayo Clin Proc. 2014;89(7):e61. doi:10.1016/j. mayocp.2013.06.030

FAQs

What causes a rash and joint pain? ›

Rheumatoid arthritis (RA) is a systemic inflammatory condition that causes joint pain, swelling, and inflammation. However, some people with RA will develop skin disease, including a rash.

What does juvenile arthritis rash look like? ›

Juvenile PsA rash typically presents as a flushed patch of skin that may appear silvery-white in areas due to an accumulation of dead skin cells. The rash is usually itchy or painful. Although it may develop anywhere on the body, it most commonly affects the following areas: the scalp.

Does rheumatoid arthritis cause skin rash? ›

Rheumatoid Arthritis Rash Causes

Inflammation of the blood vessels affects the flow of blood to the skin. This can lead to rashes and other skin symptoms. Rheumatoid arthritis rashes tend to happen during a flare-up of disease activity or in people with severe disease.

What can cause joint pain in a child? ›

The most common causes of joint pain in children are growing pains. They occur most often in children between the ages of three and nine and affect some children more than others. They can be severe enough that they interrupt sleep. Acute and overuse injuries are another common cause of joint pain in children.

What virus causes rash and joint pain? ›

Most people infected with chikungunya virus will develop some symptoms. Symptoms usually begin 3–7 days after an infected mosquito bites you. The most common symptoms are fever and joint pain. Other symptoms may include headache, muscle pain, joint swelling, or rash.

What autoimmune diseases cause rash? ›

These are the most common autoimmune diseases that may cause rashes on your skin:
  • Lupus.
  • Sjogren's syndrome.
  • Dermatomyositis.
  • Psoriasis.
  • Eczema.
  • Hypothyroidism & myxedema.
  • Celiac disease.
  • Scleroderma.
24 Jun 2022

What is Still's disease? ›

Adult Still's disease is a rare type of inflammatory arthritis that features fevers, rash and joint pain. Some people have just one episode of adult Still's disease. In other people, the condition persists or recurs. This inflammation can destroy affected joints, particularly the wrists.

What does rheumatoid arthritis look like in kids? ›

The disease may affect a few joints or many joints. It may cause symptoms all over the body. The most common symptoms include swollen, stiff, warm, red, and painful joints. Treatment options include medicines, physical therapy, healthy eating and exercise, eye exams, and rest.

Can a 5 year old have arthritis? ›

Arthritis in children is called childhood arthritis or juvenile arthritis. The most common type of childhood arthritis is juvenile idiopathic arthritis (JIA), also known as juvenile rheumatoid arthritis. Childhood arthritis can cause permanent physical damage to joints.

What kind of arthritis gives you a rash? ›

Psoriatic arthritis is a form of arthritis that typically occurs in people with psoriasis. In addition to pain, stiffness, and swelling of the joints, psoriatic arthritis can cause a red, scaly rash.

What rashes are associated with arthritis? ›

Interstitial granulomatous dermatitis is another rash that can occur with RA. Doctors may also call this condition rheumatoid papules. Symptoms associated with the condition include red plaques or bumps that closely resemble eczema. The rash is itchy and often painful.

What diseases can be mistaken for rheumatoid arthritis? ›

Conditions That Can Look Like RA
  • Lyme Disease.
  • Psoriatic Arthritis.
  • Sjögren's Syndrome.
  • Gout.
  • Fibromyalgia.
  • Lupus.
4 Sept 2022

What is the most common disorder of childhood involving chronic joint inflammation? ›

The most common type of chronic, or long-lasting, arthritis that affects children is called juvenile idiopathic arthritis (JIA). JIA broadly refers to several different chronic disorders involving inflammation of joints (arthritis), which can cause joint pain, swelling, warmth, stiffness, and loss of motion.

Can a child have rheumatoid arthritis? ›

Juvenile idiopathic arthritis, formerly known as juvenile rheumatoid arthritis, is the most common type of arthritis in children under the age of 16. Juvenile idiopathic arthritis can cause persistent joint pain, swelling and stiffness.

When should I be concerned about joint pain in children? ›

Consult your child's doctor if your child has joint pain or muscle pain that is persistent or is accompanied by: Limping or impaired activity. Persistent decreased energy or fatigue. Swollen glands (lymph nodes) in the neck, groin or underarms.

How do I know if my child has Fifths disease? ›

Signs & Symptoms

You may get a red rash on your face called “slapped cheek” rash. This rash is the most recognized feature of fifth disease. It is more common in children than adults. Some people may get a second rash a few days later on their chest, back, buttocks, or arms and legs.

What is Schnitzler syndrome? ›

Schnitzler syndrome is a rare disorder characterized by a chronic reddish rash that resembles hives (urticaria) and elevated levels of a specific protein in the blood (monoclonal IgM gammopathy).

Can meningitis cause rash is joints? ›

muscle and joint pain. pale, mottled or blotchy skin (this may be harder to see on brown or black skin) spots or a rash (this may be harder to see on brown or black skin)

What neurological disorders cause rashes? ›

Diseases that cause rashes and other skin problems also can trigger serious neurological conditions
  • Lupus. Women are 10 times more likely than men to get lupus, and the disease is especially prevalent during reproductive years. ...
  • Sjögren syndrome. ...
  • Parry-Romberg syndrome.
15 Dec 2015

What are the 7 autoimmune diseases? ›

Common autoimmune disorders include:
  • Addison disease.
  • Celiac disease - sprue (gluten-sensitive enteropathy)
  • Dermatomyositis.
  • Graves disease.
  • Hashimoto thyroiditis.
  • Multiple sclerosis.
  • Myasthenia gravis.
  • Pernicious anemia.
24 Apr 2021

What illness starts with a rash? ›

Various illnesses, such as mononucleosis, chickenpox, sixth disease, and measles, cause a viral rash. A viral rash may appear as small bumps, blisters, or patches in various parts of the body. The rash typically goes away once the illness has run its course.

What is Yamaguchi criteria? ›

The Yamaguchi criteria require the presence of five features, with at least two being major diagnostic criteria. Major criteria: Fever of at least 39°C lasting at least one week. Arthralgias or arthritis lasting two weeks or longer.

What is Vexus disease? ›

What is VEXAS syndrome? VEXAS syndrome is a disease that causes inflammatory and hematologic (blood) manifestations. The syndrome is caused by mutations in the UBA1 gene of blood cells and acquired later in life. Patients do not pass the disease to their children.

What is Still's disease in children? ›

Still's disease is a form of juvenile rheumatoid arthritis that affects children. The exact cause of Still's disease is unknown, yet it is believed to be the result of an immune disorder, in which the immune system attacks healthy cells and tissues.

What can mimic juvenile arthritis? ›

A number of other conditions can mimic juvenile arthritis, such as infections, childhood malignancies, conditions of the muscles and bones or other less common rheumatic disease. Further evaluation to exclude these may be needed before a diagnosis is confirmed.

What are the first signs of juvenile arthritis? ›

Symptoms of juvenile arthritis may include:
  • Joint stiffness, especially in the morning.
  • Pain, swelling, and tenderness in the joints.
  • Limping (In younger children, it may appear that the child is not able to perform motor skills they recently learned.)
  • Persistent fever.
  • Rash.
  • Weight loss.
  • Fatigue.
  • Irritability.
26 Aug 2021

What is the youngest age for rheumatoid arthritis? ›

Juvenile idiopathic arthritis is the most common kind of arthritis among kids and teens. Kids usually find out they have this disease between the ages of 6 months and 16 years. (You also might hear JIA called "juvenile rheumatoid arthritis," or JRA.)

Can Covid cause joint pain in kids? ›

Other signs include rash, red eyes, red cracked lips and a red swollen tongu, joint pain, an enlarged lymph node on the neck and swelling of the hands and feet, sometimes with joint pain.

How do they test for arthritis in children? ›

The doctor may order blood tests for: Erythrocyte sedimentation rate (ESR or “sed rate”) and C-reactive protein (CRP). These blood tests are measures of inflammation, or so-called inflammatory markers. They are often high in children with systemic JIA, and may be elevated in children with other forms of JIA as well.

What causes pediatric arthritis? ›

The cause of juvenile arthritis is unknown. As with most autoimmune diseases, individual cases of JIA are likely due to a combination of genetic factors, environmental exposures, and the child's immune system.

What does a psoriatic arthritis rash look like? ›

PsA rash typically looks the same as psoriasis rash. The most common type of psoriasis rash features raised patches of red skin covered with silvery-white scales. These are called plaques. Plaques may itch, burn, or hurt.

Can arthritis be a symptom of something else? ›

Yes. In addition to arthritis, joint pain can be a symptom of the following conditions: Bursitis. Fibromyalgia.

What are the early warning signs of psoriatic arthritis? ›

Symptoms
  • Swollen fingers and toes. Psoriatic arthritis can cause a painful, sausage-like swelling of your fingers and toes.
  • Foot pain. ...
  • Lower back pain. ...
  • Nail changes. ...
  • Eye inflammation.
2 Oct 2021

What is malar rash? ›

Malar rash, also named a butterfly rash, is a common facial presentation of multiple disorders. It is characterized by an erythematous flat or raised rash across the bridge of the nose and cheeks, which usually spares nasolabial folds. It may be transient or progress to involve other areas of facial skin.

Does reactive arthritis cause a rash? ›

Reactive arthritis can affect skin in a variety of ways, including mouth sores and a rash on the soles of the feet and palms of the hands.

Does lupus give you a rash? ›

Lupus facial rash

A typical sign of lupus is a red, butterfly-shaped rash over your cheeks and nose, often following exposure to sunlight. No two cases of lupus are exactly alike. Signs and symptoms may come on suddenly or develop slowly, may be mild or severe, and may be temporary or permanent.

Will a blood test detect rheumatoid arthritis? ›

Blood tests

No blood test can definitively prove or rule out a diagnosis of rheumatoid arthritis, but several tests can show indications of the condition. Some of the main blood tests used include: erythrocyte sedimentation rate (ESR) – which can help assess levels of inflammation in the body.

What is Spondyloarthritis? ›

Spondyloarthritis is a type of arthritis that attacks the spine and, in some people, the joints of the arms and legs. It can also involve the skin, intestines and eyes. The main symptom (what you feel) in most patients is low back pain. This occurs most often in axial spondyloarthritis.

What virus affects joints? ›

The most common viruses causing arthritis and/or arthralgias are parvovirus, the alphaviruses, hepatitis B, hepatitis C, Epstein-Barr virus (EBV), and tropical viruses, such as Zika and chikungunya (CHIKV).

What autoimmune disorders can cause joint pain? ›

Several autoimmune diseases can cause joint pain and other symptoms that mimic rheumatoid arthritis (RA). These diseases most commonly include lupus, systemic scleroderma, and polymyalgia rheumatic.

What chronic illness causes joint pain? ›

The most common causes of chronic pain in joints are: Osteoarthritis, a common type of arthritis, happens over time when the cartilage, the protective cushion in between the bones, wears away. The joints become painful and stiff. Osteoarthritis develops slowly and usually occurs during middle age.

What are the 3 major joint disorders? ›

Some of the diseases that affect the joints include:
  • Arthritis. Arthritis may cause joint pain and swelling. ...
  • Lupus. This autoimmune disease affects many parts of the body and can cause joint and muscle pain. ...
  • Sjögren's Syndrome. This autoimmune disease affects glands that make moisture in many parts of the body.
13 Dec 2021

Can children get lupus? ›

According to the Arthritis Foundation, about 25,000 children and adolescents have lupus or a related disorder. The disease is known to have periods of flare-ups and remissions (partial or complete lack of symptoms). Many children with lupus also have kidney problems.

Is there a blood test for juvenile rheumatoid arthritis? ›

Laboratory tests, such as certain blood tests, can help rule out other conditions and help determine the type of juvenile rheumatoid arthritis present. Tests may include: Checking for the presence of antinuclear antibodies (ANA) and igm rheumatoid factor (RF)

What causes painful joints in children? ›

The most common causes of joint pain in children are growing pains. They occur most often in children between the ages of three and nine and affect some children more than others. They can be severe enough that they interrupt sleep. Acute and overuse injuries are another common cause of joint pain in children.

Is leg pain a symptom of leukemia? ›

Bone pain can occur in leukemia patients when the bone marrow expands from the accumulation of abnormal white blood cells and may manifest as a sharp pain or a dull pain, depending on the location. The long bones of the legs and arms are the most common location to experience this pain.

Can kids have fibromyalgia? ›

When fibromyalgia occurs in children, it tends to begin between 11 and 15; it rarely occurs in children younger than 4. Family history: Relatives of people with fibromyalgia or similar pain disorders (e.g., myofascial pain syndrome) are at higher risk for fibromyalgia.

What is a sudden rash a symptom of? ›

This could be caused by an allergic reaction or an infection. Examples of rashes caused by infection include scarlet fever, measles, mononucleosis, and shingles. The rash is sudden and spreads rapidly. This could be the result of an allergy. Allergies to medications are common, and some can be serious.

What diseases have a rash as a symptom? ›

Five potentially life-threatening disorders that have skin rash as the primary symptom are:
  • Pemphigus vulgaris (PV)
  • Stevens-Johnson syndrome (SJS)
  • Toxic epidermal necrolysis (TEN)
  • Toxic shock syndrome (TSS)
  • Staphylococcal scalded skin syndrome (SSS)

How do I know if my rash is autoimmune? ›

Autoimmune hives are red, itchy, raised bumps. They vary in size from pinhead dots to large swollen lumps. You may see an eruption of one or two hives, or many hives that form a shapeless cluster or rash.

What does a cancerous rash look like? ›

Rashes & skin cancer

On the other hand, the first sign of basal cell carcinoma is usually a scaly, pink skin patch or a pearly bump that grows larger and becomes shinier over time. As the cancer progresses, an indentation may form in the center of the lesion, where it may begin to ooze or bleed.

When should I be concerned about my child's rash? ›

Consult your child's doctor if: A rash or lesion affects the eyes. Blue, red or purple dots appear in the affected area. The lesion is crusty, blistering or oozing.

What kind of rashes are serious? ›

However, a rash can be a sign of something more serious. Allergic reactions, infections, autoimmune conditions, and more can also cause rashes that need to be seen by a medical professional. Rashes that occur along with trouble breathing, fever, lightheadedness, or nausea, are a medical emergency.

What kind of viral infection causes a rash? ›

Viruses that commonly cause exanthem rash include: Chickenpox (varicella-zoster virus). COVID-19 (coronavirus). Fifth disease (parvovirus B19).

What does a viral rash look like on a child? ›

Viral rashes usually have small pink spots. They occur on both sides of the chest, stomach and back. Your child may also have a fever with some diarrhea or cold symptoms. They last 2 or 3 days.

What bacterial diseases can cause rashes? ›

Here is a rundown of the nine most common bacterial skin infections, including their causes, how to identify them, and when to seek medical help.
  • Cellulitis. ...
  • Erysipelas. ...
  • Bacterial Folliculitis. ...
  • Hot Tub Folliculitis. ...
  • Furuncles. ...
  • Carbuncles. ...
  • Impetigo. ...
  • Erythrasma.
30 Aug 2022

What cancers cause rashes? ›

Skin rash caused by cancer
  • Mycosis fungoides. One of the most common blood-related cancers is mycosis fungoides, a type of cutaneous T-cell lymphoma. ...
  • Sezary syndrome. ...
  • Leukemia. ...
  • Kaposi sarcoma. ...
  • Chronic skin conditions. ...
  • Allergic reactions. ...
  • Skin infections.
20 May 2021

What does a viral body rash look like? ›

The characteristics of viral rashes can vary greatly. However, most look like splotchy red spots on lighter skin or purplish spots on darker skin. These spots might come on suddenly or appear gradually over several days. They can also appear in a small section or cover multiple areas.

What does anxiety rash look like? ›

Hives from stress and anxiety can appear anywhere on your body. They often look like red, pink, or flesh-colored, raised, puffy, splotches. Sometimes, they may look like bug bites, or raised red bumps.

What is lupus rash? ›

A typical sign of lupus is a red, butterfly-shaped rash over your cheeks and nose, often following exposure to sunlight. No two cases of lupus are exactly alike. Signs and symptoms may come on suddenly or develop slowly, may be mild or severe, and may be temporary or permanent.

Does a lupus rash look like? ›

A lupus rash can appear in the following ways: A scaly, butterfly-shaped rash that covers both your cheeks and the bridge of your nose, This rash will not leave any scarring in its wake, but you may notice some skin discoloration such as dark or light-colored areas. Red, ring-shaped lesions that do not itch or scar.

Where do autoimmune rashes appear? ›

Dermatomyositis is a systemic autoimmune disease that often begins with arm and leg weakness as well as several different rashes including: a rash on the hands (Gottron's), around the eyes (heliotrope), and/or across the back and chest (shawl rash; see images at right).

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