Rash
| Rash | |
| A typical rash |
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Directions to Hospitals Treating Rash Risk calculators and risk factors for Rash
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Shankar Kumar, M.B.B.S. [2]]
Overview
A rash is a change in skin which affects its color, appearance, or texture. A rash may be localized to one part of the body, or affect all the skin. Rashes may cause the skin to change color, itch, become warm, bumpy, dry, cracked or blistered, swell and may be painful. The causes, and therefore treatments for rashes, vary widely. Diagnosis must take into account such things as the appearance of the rash, other symptoms, what the patient may have been exposed to, occupation, and occurrence in family members.
The presence of a rash may aid associated signs and symptoms are diagnostic of certain diseases. For example, the rash in measles is an erythematous, maculopapular rash that begins a few days after the fever starts; it classically starts at the head and spreads downwards.
Causes
Causes by Organ System
Causes in Alphabetical Order
Evaluating a Rash
The causes of a rash are extremely broad, which may make the evaluation of a rash extremely difficult. An accurate evaluation by a doctor may only be made in the context of a thorough history (What medication is the patient taking? What is the patient's occupation? Where has the patient been?) and complete physical examination.
Points to note in the examination include:
- The appearance: e.g., purpuric (typical of vasculitis and meningococcal septicemia), fine and like sandpaper (typical of scarlet fever); umbilicated lesions are typical of molluscum contagiosum (and in the past, small pox); plaques with silver scales are typical of psoriasis.
- The distribution: e.g., the rash of scarlet fever becomes confluent and forms bright red lines in the skin creases of the neck, armpits and groins (Pastia's lines); the vesicles of chicken pox seem to follow the hollows of the body (they are more prominent along the depression of the spine on the back and in the hollows of both shoulder blades); very few rashes affect the palms of the hands and soles of the feet (secondary syphilis, rickettsia or spotted fevers,[1] guttate psoriasis, hand, foot and mouth disease, keratoderma blenorrhagica);
- Symmetry: e.g., herpes zoster usually only affects one side of the body and does not cross the midline.
Typically, according to Anthony Iannazzo, it is never a good habit for one to scratch their rash; as doing so may invigorate the rash and cause it to spread. Gently rubbing the rash may provide temporary relief, but it is more than likely better to avoid contact with the affected areas altogether.
Quick Overview of Symptoms of Skin Rashes/Diseases
| Skin Disease | Symptoms | Usual Area of Body |
|---|---|---|
| Acne | Covered in small pus-filled sacs, blackheads, pimples or sore red bumps | Face, Chest or Back |
| Rosacea | Flushed appearance or Redness | Around cheeks, chin, forehead or nose |
| Boil | Painful red bump or a cluster of painful red bumps | Anywhere |
| Cellulitis | Red, tender and swollen areas of skin | Around a cut, scrape or skin breach |
| Insect bite | Red and/or itchy bumps on your skin | Anywhere and can be sprinked randomly |
| Allergic Reaction | Irregular, raised or flat red sores that appeared after taking medicine/drugs | Anywhere |
| Hives | Bumps formed suddenly | Anywhere but usually first noticed on face |
| Seborrheic dermatitis | Bumps and swelling | Near glands |
| Cradle Cap | Dry, scaly skin | Cover the head of a child |
| Irritant contact dermatitis | Red, itchy, scaly or oily rash | Eyebrows, nose, edge of the scalp, point of contact with jewellery, perfume or clothing. |
| Allergic Contact Dermatitis caused by poison ivy, oak or sumac | Red, itchy, scaly or oily rash | Eyebrows, nose, edge of the scalp, point of contact with jewellery, perfume or clothing. |
| Allergic purpura | Small red dots on your skin, or larger, bruise-like spots that appeared after taking medicine | Anywhere |
| Pityriasis Rosea | Started with a single scaly, red and slightly itchy spot, and within a few days, did large numbers of smaller patches of the rash, some red and/or others tan | Chest and Abdomen |
| Dermatitis herpetiformis | Intensely itchy rash with red bumps and blisters | Elbows, knees, back or buttocks |
| Erythema nodosum | Large red bumps that seem to bruise and are tender to touch | Anywhere |
| Psoriasis | White, Scaly rash over red, irritated skin | Elbows and knees |
| Erythema multiforme | Red, blotchy rash, with "target like" hives or sores. | Anywhere |
| Measles | Red Rash that is raised with a fever or sore throat. | Usually starts first on the forefead and face and spreads downward. |
| Chickenpox | Multiple blisters with a fever, cough, aches, tiredness and sore throat. | Usually starts first on the face, cheast and back and spreads downward. |
| Shingles | Red Blisters that are very painful and may crust | Anywhere |
| Fifth Disease | Started as a fever and then developed a bright red rash | Cheeks |
| Warts | Soft bumps forming that don't itch and have no other symptoms | Anywhere |
| Ringworm | Bald spot on your scalp or a ring of itchy red skin | Anywhere |
| Syphilis | Rash that is red but not itchy | Palms of hands or soles of feet |
| Jock Itch, Yeast Infection or Diaper rash | Red itchy rash | Groin |
| Tinea versicolor | Light coloured patches | Anywhere |
| Impetigo | Crusted, tan-colored sores | Near nose or lip |
| Scabies | Bite-like sores that itch and spread intensely | Usually start on hands or feet and spread everywhere |
| Rocky Mountain Spotted Fever | A fine rash with a fever and headache | Usually start on arms and legs including the hands and feet |
| Lupus Erythematosus | A butterfly rash with achy joints | Forehead and cheeks |
| Jaundice or sign of Hepatitis | Yellowish | Skin, whites of eyes and mouth |
| Bruise | Blue or black area after being hit | Anywhere |
| Actinic keratoses | Scaly, pink, gray or tan patches or bumps | Face, scalp or on the backs or your hands |
| Keloid or Hypertrophic scar | Scar that has grown larger than expected | Anywhere |
| Lipoma | Soft or rubbery growth | Anywhere |
| Milia | Lots of white spots | on the face of a baby |
| Molluscum or Contagiosum | Small, firm, round bumps with pits in the center that may sit on tiny stalks | Anywhere |
| Sebaceous cyst | Bump with a white dome under your skin | Scalp, nape of your neck or upper back |
| Skin Tag | Soft, fleshy growth, lump or bump | Face, neck, armpits or groin |
| Xanthelasma | Yellow area under your skin | Under Eyelids |
| Melanoma | Dark bump that may have started within a mole or blemish, or, is there a spot or mole that has changed in color, size, shape or is painful or itchy | Anywhere |
| Basal Cell Carcinoma | Fleshy, growing mass | Areas exposed to the sun |
| Squamous Cell Carcinoma | Unusual growth that is red, scaly or crusted | Face, lip or chin |
| Kaposi's Sarcoma | Dark or black raised spots on your skin that keep growing or have appeared recently | Anywhere |
Related Chapters
References
- ↑ Boyd MA, Menon P, Graves S, Gordon DL (2007). "A febrile illness with generalized papular rash involving the palms and soles". Clin Infect Dis 44: 755–756.
Symptoms and signs: circulatory (R00–R03, 785) | |||||||
|---|---|---|---|---|---|---|---|
| Cardiovascular |
| ||||||
| Myeloid/blood |
| ||||||
Symptoms and signs: respiratory system (R04–R07, 786) | |
|---|---|
| Hemorrhage | * Epistaxis |
| Abnormalities of breathing | ; Respiratory sounds: |
| Other | * Asphyxia |
| Chest, general | * Chest pain |
Symptoms and signs: skin and subcutaneous tissue (R20-R23, 782) | |
|---|---|
| Disturbances of skin sensation | Hypoesthesia - Paresthesia - Hyperesthesia |
| Other | Rash - Cyanosis - Pallor - Flushing - Petechia - Desquamation - Induration - Diaphoresis |
Symptoms and signs: nervous and musculoskeletal systems (R25-R29, 781) | |
|---|---|
| Abnormal involuntary movements (see also movement disorders) | Tremor - Spasm - Fasciculation - Athetosis |
| Gait abnormality | Scissor gait - Antalgic gait - Cerebellar ataxia - Festinating gait - Pigeon gait - Propulsive gait - Steppage gait - Stomping gait - Spastic gait - Myopathic gait - Magnetic gait - Trendelenburg gait |
| Lack of coordination | Ataxia (Cerebellar ataxia, Sensory ataxia) - Dysmetria - Dysdiadochokinesia - Hypotonia |
| Other | Tetany - Meningism - Hyperreflexia - Opisthotonus - Abnormal posturing - Hemispatial neglect |
Symptoms and signs: urinary system (R30-R39, 788) | |
|---|---|
| General | Renal colic - Dysuria - Vesical tenesmus - Urinary incontinence - Urinary retention - Oliguria - Polyuria - Nocturia - Extravasation of urine - Extrarenal uremia |
Symptoms and signs: cognition, perception, emotional state and behaviour (R40-R46, 780-781) | |
|---|---|
| General | Anxiety - Somnolence - Coma - Amnesia (Anterograde amnesia, Retrograde amnesia) - Dizziness/Vertigo |
| Olfaction | Anosmia - Parosmia |
| Taste | Ageusia - Parageusia |
Symptoms and signs: Speech and voice (R47-R49, 784) | |
|---|---|
| Aphasia/Dysphasia | Expressive aphasia - Receptive aphasia - Conduction aphasia |
| Other speech disturbances | Dysarthria - Schizophasia |
| Symbolic dysfunctions | Dyslexia - Alexia - Agnosia (Prosopagnosia) - Apraxia - Acalculia - Agraphia |
| Voice disturbances | Dysphonia - Aphonia |
Symptoms and signs: general (R50-R69, 780-789) | |
|---|---|
| General | Fever (Hyperpyrexia) - Headache - Chronic pain - Malaise/Fatigue (Asthenia, Debility) - Fainting (Vasovagal syncope) - Febrile seizure - Shock (Cardiogenic shock) - Lymphadenopathy - Edema (Peripheral edema, Anasarca) - Hyperhidrosis (Sleep hyperhidrosis) - Delayed milestone - Failure to thrive - Short stature (Idiopathic) - food and fluid intake (Anorexia, Polydipsia, Polyphagia) - Cachexia - Xerostomia - Clubbing - Tenderness |
Symptoms and signs: Symptoms concerning nutrition, metabolism and development (R62–R64, 783) | |
|---|---|
| Ingestion/Weight | |
| Growth | Delayed milestone • Failure to thrive • Short stature (e.g., Idiopathic) |
Table of Contents In Alphabetical Order | By Individual Diseases | Signs and Symptoms | Physical Examination | Lab Tests | Drugs
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