From the Research
No, the rash in roseola is not typically lacy. Roseola (also called exanthem subitum or sixth disease) is characterized by a distinctive rose-pink, maculopapular rash that appears after a high fever subsides. The rash consists of small, flat or slightly raised pink spots that are discrete but may merge in some areas, as described in the most recent review of roseola infantum 1. It typically starts on the trunk and then spreads to the neck, face, arms, and legs. Unlike the lacy rash seen in conditions like fifth disease (erythema infectiosum), roseola's rash has a more uniform, spotty appearance. The rash is non-itchy and blanches when pressed. Roseola is most common in children 6 months to 2 years old, caused primarily by human herpesvirus 6 (HHV-6), and the rash typically lasts 1-2 days before fading without treatment. Some key characteristics of the rash in roseola include:
- Discrete, rose-pink in color, circular or elliptical, macular or maculopapular
- Measuring 2 to 3 mm in diameter
- First seen on the trunk, then spreads to the neck and proximal extremities
- Typically blanches on pressure and subsides in 2 to 4 days without sequelae The disease follows a characteristic pattern of high fever for 3-5 days that resolves abruptly, followed by the appearance of the rash as the fever breaks, as noted in studies on the clinical manifestations of roseola infantum 1, 2.