What should you know about hand foot and mouth disease rash?

The spots may be flat or raised and can contain clear fluid. They may appear on the palms, fingers, soles, toes, buttocks, legs or arms. Mouth sores can make eating and drinking uncomfortable. Some children have only a few visible lesions, while others have a wider pattern. Many childhood rashes resemble one another, so the distribution, accompanying symptoms and examination matter more than a photograph or a single spot.

Clean the skin gently and pat it dry. Keep nails short, discourage scratching, and use loose clothing that does not catch on lesions. Do not pop blisters or use steroid, antibiotic or antiseptic products unless a clinician recommends them. Offer cool drinks and soft foods for mouth discomfort. Wash hands after caring for the child, clean shared surfaces, and avoid sharing cups, utensils and towels.

Seek medical advice if the rash is rapidly worsening, unusually painful, spreading with warmth or swelling, or producing pus. Get prompt help when mouth pain prevents drinking, urination falls noticeably, the child is hard to wake, breathing is difficult, or a fever is persistent or worrying. Review is also appropriate when the rash has an unusual appearance or another diagnosis is possible.

Does the rash match hand, foot and mouth disease? How should we care for any open areas? What can my child safely take for discomfort? When is return to nursery or school reasonable?