[Question #444] Rash on cheeks of a 5 year old kid

34 months ago
Hi Doctor Hunter,

My kid is 5 years and she got a rash on her cheek. The doctor (pediatrician) said there is no issue and it is not herpes. Me and my wife is not HSV1 or 2. 
She don't have fever.  Tiredness or anything.  She is eating fine and with good energy. 
She slept well, she don't have any pain in the area or around.  But she did tell it itches some times. 
We saw it first on Friday morning, while i was helping her getting brushed for school. 
Physical examination from pediatrician says it could be some viral and not herpes.  As they are very small.

But a doc from India from the pic I posted said it looks like herpes.https://www.dropbox.com/sh/ej6a2wex0mv67bo/AABGuTN7FuWfFhkmIVkCMdvEa?dl=0 .  This video is from last night and the photo's are from this morning. 

I have got an appointment from a dermatologist on Monday 18th Jan.  I am worried and anxious if she got this ugly virus in her body. 

She goes to school, but no one in our friends or family got this, and we don't kiss her on face or let anyone do.  I am not sure if it is an infection from the carpet as some times while playing she used to put her cheek on the carpet. 

Any help is really appreciated, and please let me know if you need any further information. 

Regards,

Sree







H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
34 months ago
Welcome to Ask the Expert. Normally Terri Warren answers herpes related questions, but I think you attempted to contact me by email so I am responding.

As a matter of policy we do not examine posted photos of skin rashes or other lesions. We offer general medical advice, but not direct clinical care. We cannot attempt a specific diagnosis.

Any 5 year old can contract HSV1 from playmates. The majority of people in India have positive blood tests for HSV1, mostly acquired in childhood from other children. However, I doubt that is what she has. If initial HSV infections cause symptoms at all, usually it is more severe, often with fever and severe sore throat. Second, all pediatricians are very experienced in both childhood rash infections and herpes, and in-person examination is much more reliable than distant assessment by photography (which is another reason we don't examine such images on this forum). Therefore, your pediatrician's opinion probably is more reliable than the dermatologist's.

It will be interesting to hear what the dermatologist says after direct examination, but I'm betting s/he will diagnose something other than herpes. But as already suggested, even if it turns out to be herpes after all, this isn't anything to be seriously worried about. As I said, most people in your country have HSV1 and it's very common in childhood. And in case you are wondering, this has nothing to do with economics or social class. HSV1 is equally common in all strata of all societies.

I hope this information has been helpful. Best wishes--  HHH, MD


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34 months ago
Thanks a lot Doc.

Ware in the United states now and what is there on her cheeks are small rash like hive no blisters.  She don't have fever and she does got cold (nasal congestion) and cough.  Hopefully there is nothing to worry right? I will reply once i have the dermatologist see her. 

The pediatrician here clinically examined her and touched the rash and said there is nothing looks like Herpes.  So I think I have to go by his words than the one from doctors on forum.  

I will update you as soon as I have the session done with Dermatologist.   On another note the redness is gone, and the reash bumps are more like hives than a blister. 




H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
34 months ago
Sorry I misunderstood where you are. I misunderstood the reference to India. HSV1 isn't as common in the US as India, but still very common and usually acquired in childhood from other children. But from your further description, I am even more confident this isn't herpes.

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33 months ago
Hi Doc,

The dermatologist examined and mentioned it is Periorificial dermatitis or perioral-dermatitis.  

Thanks a lot!!
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
33 months ago
Glad to hear your fears were not confirmed! (But of course not surprised.) Best wishes.

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