Ring-Shaped Hives in Young Children
Urticaria multiforme, also called acute annular urticaria, is a benign skin reaction seen mostly in children between about 4 months and 4 years old. It can look alarming because the welts form rings or bruise-like patches, but the rash is usually harmless and short-lived.
What It Looks Like
Ring-shaped or arc-shaped welts with a clearer or purplish center appear on the trunk and limbs and sometimes the face. Children may have swollen hands, feet or eyelids but often do not seem very itchy. Individual welts last less than 24 hours, although the whole episode can last days.
Likely Causes
Viral infections and sometimes antibiotics are the most common triggers. In many children, the cause is never confirmed. See viral hives and baby hives.
How It Differs From Similar Conditions
- Erythema multiforme: fixed target lesions that last more than a week
- Serum sickness-like reaction: joint pain and fever, often after antibiotics
- Kawasaki disease: prolonged fever with red eyes and lips
Treatment
Treatment is usually supportive: a pediatrician-approved antihistamine if needed and stopping any suspect medication under medical guidance. The rash typically clears within a few days to three weeks without scarring.
When to Call 911
Call 911 or go to the emergency room right away if your child has hives along with trouble breathing, wheezing, swelling of the lips, tongue or face, repeated vomiting, unusual sleepiness or floppiness, pale or bluish skin, or seems seriously unwell. Hives in a young child can be a sign of a severe allergic reaction.
When to See a Doctor
See a doctor if your symptoms last more than a few days, keep coming back, cover large areas, or interfere with sleep or daily life. Dr. Tiffany Young founded the Hives Treatment Center in San Francisco, a practice focused on diagnosing and treating urticaria multiforme.
Related Reading
You may also find these guides helpful: causes of hives and hives symptoms.
Frequently Asked Questions About Urticaria Multiforme
Is urticaria multiforme dangerous?
Usually not, but a pediatrician should confirm the diagnosis.
Will it come back?
It may recur with another viral illness, but many children have only one episode.
Is it contagious?
The rash is not, though the virus that triggered it may be.
Get Relief for Your Hives
A doctor can tell this harmless rash from more serious look-alikes. Visit our hives treatment page to see the latest treatment options for your outbreak.
This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. If you think you are having a medical emergency, call 911.
