Rubella in children is a mild eruptive pestilence disease, commonly seen in children under five years old.

Rubella is also known as "rubella," Jingui Yaolue refers to it as "urticaria," and the "Complete Book of Pediatrics" calls it "rubella."

Eruptions, including measles, rubella, roseola infantum, and scarlatina, are among the four major pediatric conditions. This article focuses on differentiating rubella in children and includes infantile roseola infantum. For other conditions, please refer to the sections on "childhood measles" and "childhood scarlatina."

bubble_chart Pattern Analysis

1. Defense Phase Pathogenic Heat︰At the onset, there is aversion to wind and fever, with the fever generally not high, lasting 1 to 2 days. Soon after, rashes appear all over the body, first on the head, face, and trunk, then spreading to the limbs, often covering the entire body within a day. The rashes are light red, fine, sparse, and accompanied by itching. Swollen lymph nodes are present behind the ears and at the occipital bone, along with cough, sneezing, runny nose, sore throat, red eyes, etc. The tongue coating is thin and white, the finger veins appear red-purple, and the pulse is floating and rapid. This condition is mainly caused by the invasion of external seasonal pathogens, which contend with qi and blood, stagnate in the muscles, and manifest on the skin. However, as the pathogen is relatively mild, it generally only affects the defensive aspect. The key diagnostic features are: rashes appear shortly after the fever begins, usually within one or two days, and the eruption progresses very quickly, typically completing within 24 hours. The rash consists of fine, scattered red dots, pale red in color, resembling sand, first appearing on the head and face, then spreading to the trunk, limbs, and finally the whole body, with no rash on the palms or soles. The rashes fade gradually in the order of their appearance within one or two days, accompanied by itching during the eruption. After fading, there is no desquamation or scarring, and systemic symptoms are mild. Swollen lymph nodes behind the ears may also be observed.
2. Qi Fen Pathogenic Heat︰High fever, bright red rash with dense spots, thirst with desire to drink, dysphoria, dry stool, dark urine, thin yellow tongue coating, rapid and strong pulse, red-purple finger venules reaching the qi pass. Due to intense heat toxin, pathogenic heat invades the qi aspect, and symptoms gradually worsen. The distinguishing features are: high fever caused by internal heat radiating outward, the rash color changing from pale red to bright red, the rash pattern shifting from fine and scattered to dense, accompanied by thirst with desire to drink, dysphoria, dry stool, and scanty dark urine.

Note: Infantile roseola

Infantile roseola is an acute eruptive pestilence disease, the disease cause mechanism is roughly the same as rubella, but the clinical symptoms are different, the key points for symptom differentiation are:

1. Age of onset: The age of onset for roseola infantum is younger than that of rubella, mostly seen in infants under one year old;
2. Rash type: The rash of roseola infantum is finer and denser than that of rubella;
3. Rash color: Rubella presents a light red color, while roseola infantum presents a rose color with a light red halo around it;
4. During the eruption, rubella causes itching of the skin, while roseola infantum does not;
5. Time of eruption: Rubella shows rash spots at the same time as fever, while roseola infantum shows rash spots after the fever subsides;
6. Sequence of eruption: It first appears on the neck, face, trunk, limbs, and the palms and soles of the feet have no rash. The treatment method is similar to that of rubella.

bubble_chart Documentation

1. Jingui Yaolue．"Abnormal Pulse Syndrome and Treatment": "When wind and qi contend, if wind is strong, it results in urticaria."
2. Zhubing Yuanhou Lun．"Wind-Induced Itching and Hidden Rash": "When children sweat and remove their clothes, wind enters the striae and interstices, contending with qi and blood, leading to the formation of hidden rashes. Wind qi remains superficial in the striae and interstices, its force mild, hence there is no swelling or pain, only the formation of hidden rashes and cutaneous pruritus."
3. Youyou Jicheng．"Macula and Papule Urticaria Treatment": "Red dots appearing within the skin without emerging belong to the Shaoyin monarch fire, known as rashes. When these symptoms appear sparsely on the chest, abdomen, hands, and feet, it is due to rootless and uncontrolled fire gathering in the chest, steaming up to the lungs, and hiding in the skin to form small rashes, resembling mosquito bites or flea marks rather than brocade patterns." "Urticaria mostly pertains to the spleen, as it is hidden within the skin, often itchy when it appears, or not red, commonly known as wind dan."
4. 《Maco Huoren Quanshu．Differences Between True Measles, Roseola Infantum, and Rubella》: "Roseola infantum refers to red spots all over the body of a newborn within the first month, mottled like cinnabar, caused by heat toxin received in the mother's womb, hence appearing on the skin after birth, not to be mistaken for seasonal epidemic measles, and not to be treated with decoction." "Rubella, somewhat similar to measles, occurs in infants within the first month, half a year, or one year of age, during hot weather, triggered by wind-heat. This is not due to fetal toxin but a minor skin ailment caused by wind-heat affecting the spleen and lungs, not classified under true measles."