Painful redness of the hands and feet in children can stem from several causes. These can be infective or immune-mediated, and can be true rashes or might be due to vascular and other phenomena. By identifying the nature of the onset of redness, the presence of associated symptoms and whether the redness resolves on its own, the cause can be identified and if possible, eradicated.
Hand, Foot and Mouth Disease
Hand, foot and mouth disease is caused by several members of the enterovirus family, most commonly coxsackie virus A16. The disease usually manifests with a fever, sore throat and general malaise. A few days later, painful sores in the mouth erupt, followed by a non-itchy rash on the palms and soles, and sometimes on the buttocks and genitalia as well. HFMD has no specific cure -- treatment consists of supportive measures and pain relief.
Kawasaki's disease is a condition that involves inflammation of the blood vessels. It begins with a high fever that's unresponsive to regular doses of acetaminophen. Associated symptoms include painful redness of the palms and soles, joint pains, red eyes and swollen lymph nodes. Kawasaki's disease requires hospitalization and intravenous medication to prevent complications.
Infective endocarditis is an infection and inflammation of the heart's valves and lining. Sometimes, in later stages of the disease, pieces of infective material can enter the circulation and create pockets of infection in the palms and soles. These are called Janeway lesions. Infective endocarditis is a serious condition and should be treated urgently in a hospital setting.
Derangements in the blood vessels can cause painful redness in the hands and feet as well. Children with sickle cell anemia can have what are called vaso-occlusive crises, wherein the blood cells clump together and block off vessels to the digits of the hands and feet.
Another such condition is Raynaud's phenomenon, which causes spasm of the blood vessels when exposed to cold.