A rash is among the most common symptoms of Kawasaki disease. Kawasaki disease is an inflammatory condition affecting blood vessels that commonly develops in children under five.

Kawasaki disease is a type of autoimmune vasculitis. Autoimmune vasculitis is a group of conditions involving inflammation in the blood vessels due to damage from the immune system.

Kawasaki disease is the leading cause of acquired vasculitis in developed countries such as the United States. Acquired means it develops after birth due to environmental influences.

Rashes are a characteristic sign of Kawasaki disease. These rashes can vary in appearance but can appear on the trunk, limbs, or genital areas.

Roughly 5,000 children have to visit the hospital each year with Kawasaki disease. It is also known by several other names, including Kawasaki syndrome or mucocutaneous lymph node syndrome.

Children with Kawasaki disease develop inflammation in their small and medium-sized blood vessels that can cause sudden illness.

The exact cause of Kawasaki disease is unknown, but it’s thought to potentially relate to wind-borne or water-borne infections that trigger an abnormal immune response in genetically-prone people. Siblings of people with Kawasaki disease have a 10 to 20 times higher chance of developing it too.

What is a Kawasaki rash?

A rash is a common sign of Kawasaki disease, and the appearance of a rash can help guide doctors toward a diagnosis of Kawasaki disease.

Almost all children with Kawasaki disease develop a rash.

Rashes may appear similar to those caused by diseases such as measles or scarlet fever, typically appearing:

  • on the trunk
  • on the limbs
  • around the groin area

The pattern of the rash can vary between children. Typical rash patterns include:

  • Maculopapular rash: Maculopapular rashes are the most common pattern seen in children with Kawasaki disease. They include flat, discolored spots and raised bumps.
  • Scarlatiniform rash: A red, bumpy rash that feels rough to the touch and typically appears on the chest or abdomen. It gets its name from resembling rashes caused by scarlet fever.
  • Urticarial rash: Urticaria is the medical term for hives. These rashes include raised wheals on the skin.

Rashes from Kawasaki disease aren’t typically itchy.

A Kawasaki rash typically develops in children under the age of five.

It may include symptoms such as:

It’s important to seek immediate medical attention if your child develops characteristic signs of Kawasaki disease. Most children who receive treatment in a hospital make a full recovery.

Despite over 50 years of investigation, the exact cause of Kawasaki disease still isn’t clear. Its name comes from Tomisaku Kawasaki, the Japanese doctor who identified 50 cases in 1967 and proposed it as a new disease.

Later investigations suggested that it was a new disease in Japan after World War II, although a similar pattern of symptoms is found in Western countries such as the United States.

It’s been suggested that infections that can travel through the wind or water may trigger an autoimmune reaction in genetically prone people that leads to Kawasaki disease. Research from Japan and Toronto, Canada, suggests that fungal particles carried by wind link with an increase in cases.

The diagnosis for Kawasaki disease is clinical, meaning it’s made based on characteristic signs and symptoms rather than the results of any particular test.

At least two mnemonics can help doctors recognize these signs and symptoms: “warm CREAM” and “FEBRILE.”

  • warm = Fever for more than 5 days
  • C = Conjunctivitis (pink eye)
  • R = Rash
  • E = Edema (swelling) or erythema (discoloration) of hands or feet
  • A = Adenopathy (swollen lymph nodes) around the neck
  • M – Mucosal erythema (discoloration and crusting around the mouth)

FEBRILE

  • F = Fever for more than 5 days
  • E = Enanthem (rash) around the mouth
  • B = Bulbar conjunctivitis (pink eye)
  • R = Rash
  • I = Internal organ involvement, inflammation of arteries in the heart, liver, testicles, or other internal organs
  • E = Extremeity changes, discoloration, and swelling in the limbs

A hospital needs to administer treatment for Kawasaki disease. It involves a combination of aspirin and intravenous immunoglobulin, a concentrated form of antibodies.

It’s important to seek immediate medical attention if you suspect your child has Kawasaki disease to initiate treatment quickly and avoid long-term complications.

Most children with Kawasaki disease make a full recovery without long-term complications if they receive treatment. The ideal time to treat Kawasaki disease is within 4 to 5 days of fever onset, but even treating it within the first 10 days is associated with a lower risk of heart damage.

Intravenous immunoglobulin reduces the chances of developing a coronary artery aneurysm from about 25% to 5%. A coronary artery aneurysm occurs when a blood vessel that supplies your heart with blood bulges.

Rashes are a characteristic sign of Kawasaki disease. These rashes appear around the trunk, limbs, or groin. They often appear shortly after the development of a fever and other characteristic signs of Kawasaki disease

It’s important to seek immediate medical attention if your children develop signs of Kawasaki disease. Most children make a full recovery with treatment, but the risk of permanent heart damage rises when there is a delay in treatment.