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Rashes

Skin redness or inflammation; Skin lesion; Rubor; Skin rash; Erythema

 

Rashes involve changes in the color, feeling or texture of your skin.

Considerations

 

Often, the cause of a rash can be determined from how it looks and its symptoms. Other times, the cause of the rash remains unknown.

 

Causes

 

A simple rash is called dermatitis, meaning inflammation of the skin. Contact dermatitis is caused by things your skin touches, such as:

  • Chemicals in elastic, latex, and rubber products
  • Cosmetics, soaps, and detergents
  • Dyes and other chemicals in clothing
  • Poison ivy, oak, or sumac

Seborrheic dermatitis is a rash that appears in patches of redness and scaling around the eyebrows, eyelids, mouth, nose, trunk, and behind the ears. If it happens on your scalp, it is called dandruff in adults and cradle cap in infants.

Age, stress, fatigue, weather extremes, oily skin, infrequent shampooing, and alcohol-based lotions aggravate this harmless but bothersome condition.

Other common causes of a rash include:

  • Eczema (atopic dermatitis). Tends to happen in people with allergies or asthma. The rash is generally red, itchy, and scaly.
  • Psoriasis. Tends to occur as red, scaly, itchy patches over joints and along the scalp. Fingernails may also be affected.
  • Impetigo. Common in children, this infection is from bacteria that live in the top layers of the skin. It appears as red sores that turn into blisters, ooze, then for a honey colored crust over.
  • Shingles. A painful blistered skin condition caused by the same virus as chickenpox. The virus can lie dormant in your body for many years and re-emerge as shingles. It usually affects only one side of the body.
  • Childhood illnesses such as chickenpox, measles, roseola, rubella, hand-foot-mouth disease, fifth disease, and scarlet fever.
  • Medicines and insect bites or stings.

Many medical conditions can cause a rash as well. These include:

  • Lupus erythematosus (an immune system disease)
  • Rheumatoid arthritis, especially the juvenile type
  • Kawasaki disease (inflammation of the blood vessels)
  • Certain body-wide (systemic) viral, bacterial or fungal infections

 

Home Care

 

Most simple rashes will improve with gentle skin care and by avoiding irritating substances. Follow these general guidelines:

  • Avoid scrubbing your skin.
  • Use as little soap as possible. Use gentle cleansers instead.
  • Avoid applying cosmetic lotions or ointments directly on the rash.
  • Use warm (not hot) water for cleaning. Pat dry, don't rub.
  • Stop using any recently added cosmetics or lotions.
  • Leave the affected area exposed to the air as much as possible.
  • Try calamine medicated lotion for poison ivy, oak, or sumac, as well as for other types of contact dermatitis.

Hydrocortisone cream (1%) is available without a prescription and may soothe many rashes. Stronger cortisone creams are available with a prescription. If you have eczema, apply moisturizers over your skin. Try oatmeal bath products, available at drugstores, to relieve symptoms of eczema, psoriasis, or shingles. Oral antihistamines may help relieve itchy skin.

 

When to Contact a Medical Professional

 

Call 911 if:

  • You are short of breath, your throat is tight, or your face is swollen
  • Your child has a purple rash that looks like a bruise

Call your health care provider if:

  • You have joint pain, fever, or a sore throat
  • You have streaks of redness, swelling, or very tender areas as these may indicate an infection
  • You are taking a new medicine -- DO NOT change or stop any of your medicines without talking to your doctor
  • You may have a tick bite
  • Home treatment doesn't work, or your symptoms get worse

 

What to Expect at Your Office Visit

 

Your provider will perform a physical examination and ask questions about your medical history and symptoms. Questions may include:

  • When did the rash begin?
  • What parts of your body are affected?
  • Does anything make the rash better? Worse?
  • Have you used any new soaps, detergents, lotions, or cosmetics recently?
  • Have you been in any wooded areas recently?
  • Have you had any change in your medicines?
  • Have you noticed a tick or insect bite?
  • Have you eaten anything unusual?
  • Do you have any other symptoms, like itching or scaling?
  • What medical problems do you have, such as asthma or allergies?
  • Have you recently traveled out of the area where you live?

Tests may include:

  • Allergy testing
  • Blood tests
  • Skin biopsy
  • Skin scrapings

Depending on the cause of your rash, treatments may include medicated creams or lotions, medicines taken by mouth, or skin surgery.

Many primary care providers are comfortable dealing with common rashes. For more complicated skin disorders, you may need a referral to a dermatologist.

 

 

References

James WD, Berger TG, Elston DM. Cutaneous signs and diagnosis. In: James WD, Berger TG, Elston DM, eds. Andrews' Diseases of the Skin: Clinical Dermatology. 11th ed. Philadelphia, PA: Elsevier; 2016:chap 2.

Seller RH, Symons AB. Skin problems. In: Seller RH, Symons AB, eds. Differential Diagnosis of Common Complaints. 6th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 29.

Shaw JC. Examination of the skin and an approach to diagnosing skin diseases. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 436.

 
  • Poison oak rash on the arm

    Poison oak rash on the arm - illustration

    Poison oak rash on the arm. Several plants produce toxins that cause skin reaction. This is the appearance of poison oak dermatitis. Note the typical linear streaks produced either by scratching or brushing against the plant. (Image courtesy of the Centers for Disease Control and Prevention.)

    Poison oak rash on the arm

    illustration

  • Erythema toxicum on the foot

    Erythema toxicum on the foot - illustration

    Newborn infants may have Erythema toxicum, a rash that is characterized by patchy redness with central vesicles. The rash is temporary, and the location may move (transient). (Image courtesy of the Centers for Disease Control and Prevention.)

    Erythema toxicum on the foot

    illustration

  • Acrodermatitis

    Acrodermatitis - illustration

    Acrodermatitis enteropathica is a skin condition peculiar to children that may be accompanied by mild symptoms of fever and malaise. It may also be associated with hepatitis B infection or other viral infections. The lesions appear as small coppery-red, flat-topped firm papules that appear in crops and sometime in long linear strings, often symmetric.

    Acrodermatitis

    illustration

  • Roseola

    Roseola - illustration

    Roseola is an acute disease of infants and young children that is characterized by high fever followed by a rash that appears on trunk, limbs, neck and face.

    Roseola

    illustration

  • Shingles

    Shingles - illustration

    Shingles, or herpes zoster, is caused by the same virus that causes chickenpox. The virus can lie dormant in the body for many years and re-emerge as shingles. Shingles appear as a painful rash. It consists of red patches of skin with small blisters (vesicles) that look very similar to early chickenpox. Shingles usually clears in 2 to 3 weeks and rarely recurs.

    Shingles

    illustration

  • Cellulitis

    Cellulitis - illustration

    Cellulitis is a deep infection of the skin, usually accompanied by generalized (systemic) symptoms such as fever and chills. The area of redness increases in size as the infection spreads. The center of the circled lesion has been biopsied.

    Cellulitis

    illustration

  • Erythema annulare centrifugum - close-up

    Erythema annulare centrifugum - close-up - illustration

    When redness appears in ring shapes on the body, it is referred to as erythema annulare, shown here on the forearm. There are generally no symptoms, with the exception of mild itching (pruritus). It may be associated with serious diseases, but in the majority of cases, an underlying illness is never discovered.

    Erythema annulare centrifugum - close-up

    illustration

  • Psoriasis, guttate on the arms and chest

    Psoriasis, guttate on the arms and chest - illustration

    This is a picture of guttate (drop-shaped) psoriasis on the arms and chest. Guttate psoriasis is a rare form of psoriasis. It frequently follows a streptococcal infection, appears rapidly and affects the face, chest, and nearest limbs. The patches are small and round or oval and have the typical appearance of psoriasis. This photograph shows the diffuse and widespread coverage on the arm and chest.

    Psoriasis, guttate on the arms and chest

    illustration

  • Psoriasis, guttate on the cheek

    Psoriasis, guttate on the cheek - illustration

    This is a picture of guttate (drop-shaped) psoriasis on face and neck. Guttate psoriasis is a rare form of psoriasis. It frequently follows a streptococcal infection, appears rapidly and affects the face, chest, and nearest limbs. The patches are small and round or oval and have the typical appearance of psoriasis. This photograph shows the diffuse and widespread coverage on the face and neck.

    Psoriasis, guttate on the cheek

    illustration

  • Systemic lupus erythematosus rash on the face

    Systemic lupus erythematosus rash on the face - illustration

    This is a picture of a systemic lupus erythematosis rash on the face. Lupus erythematosis often produces a "butterfly rash" or malar rash. Typically, the rash also appears on the nose.

    Systemic lupus erythematosus rash on the face

    illustration

  • Poison ivy on the knee

    Poison ivy on the knee - illustration

    This is a typical early appearance of a poison ivy rash, located on the knee. These early lesions consist of multiple small blisters (vesicles), often in a line where the skin has brushed against the poison ivy plant.

    Poison ivy on the knee

    illustration

  • Poison ivy on the leg

    Poison ivy on the leg - illustration

    This is a typical early appearance of a poison ivy rash, located on the leg. These early lesions consist of multiple small blisters, often in a line where the skin has brushed against the poison ivy plant. The rash is caused by skin contact with the oily sap (resin) of these plants. The oily resin usually enters the skin rapidly, and is seldom transferred from person to person. The rash is not caused by the fluid from the blisters. Thus, once the person has washed the oil off the skin, the rash is usually not contagious.

    Poison ivy on the leg

    illustration

  • Erythema multiforme, circular lesions - hands

    Erythema multiforme, circular lesions - hands - illustration

    Erythema multiforme lesions are circular and may appear in concentric rings (often called target lesions). Target lesions may also be associated with other medical conditions such as herpes infection, streptococcal infection, tuberculosis (TB), or as a reaction to chemicals or medications.

    Erythema multiforme, circular lesions - hands

    illustration

  • Erythema multiforme, target lesions on the palm

    Erythema multiforme, target lesions on the palm - illustration

    Erythema multiforme lesions are often referred to as target lesions because of the concentric rings the lesions produce. The "target" appearance is well demonstrated in this photograph.

    Erythema multiforme, target lesions on the palm

    illustration

  • Erythema multiforme on the leg

    Erythema multiforme on the leg - illustration

    The red spots on this person's back appear where blisters (bullae) caused by Erythema multiforme have ruptured and the overlying skin removed (denuded). The resulting lesions are yellow-crusted ulcers (erosions). Erythema multiforme may be associated with herpes simplex infection, mycoplasma pneumonia, or other medical conditions such as streptococcal infection, tuberculosis (TB), or may result from exposure to chemicals or medications.

    Erythema multiforme on the leg

    illustration

    • Poison oak rash on the arm

      Poison oak rash on the arm - illustration

      Poison oak rash on the arm. Several plants produce toxins that cause skin reaction. This is the appearance of poison oak dermatitis. Note the typical linear streaks produced either by scratching or brushing against the plant. (Image courtesy of the Centers for Disease Control and Prevention.)

      Poison oak rash on the arm

      illustration

    • Erythema toxicum on the foot

      Erythema toxicum on the foot - illustration

      Newborn infants may have Erythema toxicum, a rash that is characterized by patchy redness with central vesicles. The rash is temporary, and the location may move (transient). (Image courtesy of the Centers for Disease Control and Prevention.)

      Erythema toxicum on the foot

      illustration

    • Acrodermatitis

      Acrodermatitis - illustration

      Acrodermatitis enteropathica is a skin condition peculiar to children that may be accompanied by mild symptoms of fever and malaise. It may also be associated with hepatitis B infection or other viral infections. The lesions appear as small coppery-red, flat-topped firm papules that appear in crops and sometime in long linear strings, often symmetric.

      Acrodermatitis

      illustration

    • Roseola

      Roseola - illustration

      Roseola is an acute disease of infants and young children that is characterized by high fever followed by a rash that appears on trunk, limbs, neck and face.

      Roseola

      illustration

    • Shingles

      Shingles - illustration

      Shingles, or herpes zoster, is caused by the same virus that causes chickenpox. The virus can lie dormant in the body for many years and re-emerge as shingles. Shingles appear as a painful rash. It consists of red patches of skin with small blisters (vesicles) that look very similar to early chickenpox. Shingles usually clears in 2 to 3 weeks and rarely recurs.

      Shingles

      illustration

    • Cellulitis

      Cellulitis - illustration

      Cellulitis is a deep infection of the skin, usually accompanied by generalized (systemic) symptoms such as fever and chills. The area of redness increases in size as the infection spreads. The center of the circled lesion has been biopsied.

      Cellulitis

      illustration

    • Erythema annulare centrifugum - close-up

      Erythema annulare centrifugum - close-up - illustration

      When redness appears in ring shapes on the body, it is referred to as erythema annulare, shown here on the forearm. There are generally no symptoms, with the exception of mild itching (pruritus). It may be associated with serious diseases, but in the majority of cases, an underlying illness is never discovered.

      Erythema annulare centrifugum - close-up

      illustration

    • Psoriasis, guttate on the arms and chest

      Psoriasis, guttate on the arms and chest - illustration

      This is a picture of guttate (drop-shaped) psoriasis on the arms and chest. Guttate psoriasis is a rare form of psoriasis. It frequently follows a streptococcal infection, appears rapidly and affects the face, chest, and nearest limbs. The patches are small and round or oval and have the typical appearance of psoriasis. This photograph shows the diffuse and widespread coverage on the arm and chest.

      Psoriasis, guttate on the arms and chest

      illustration

    • Psoriasis, guttate on the cheek

      Psoriasis, guttate on the cheek - illustration

      This is a picture of guttate (drop-shaped) psoriasis on face and neck. Guttate psoriasis is a rare form of psoriasis. It frequently follows a streptococcal infection, appears rapidly and affects the face, chest, and nearest limbs. The patches are small and round or oval and have the typical appearance of psoriasis. This photograph shows the diffuse and widespread coverage on the face and neck.

      Psoriasis, guttate on the cheek

      illustration

    • Systemic lupus erythematosus rash on the face

      Systemic lupus erythematosus rash on the face - illustration

      This is a picture of a systemic lupus erythematosis rash on the face. Lupus erythematosis often produces a "butterfly rash" or malar rash. Typically, the rash also appears on the nose.

      Systemic lupus erythematosus rash on the face

      illustration

    • Poison ivy on the knee

      Poison ivy on the knee - illustration

      This is a typical early appearance of a poison ivy rash, located on the knee. These early lesions consist of multiple small blisters (vesicles), often in a line where the skin has brushed against the poison ivy plant.

      Poison ivy on the knee

      illustration

    • Poison ivy on the leg

      Poison ivy on the leg - illustration

      This is a typical early appearance of a poison ivy rash, located on the leg. These early lesions consist of multiple small blisters, often in a line where the skin has brushed against the poison ivy plant. The rash is caused by skin contact with the oily sap (resin) of these plants. The oily resin usually enters the skin rapidly, and is seldom transferred from person to person. The rash is not caused by the fluid from the blisters. Thus, once the person has washed the oil off the skin, the rash is usually not contagious.

      Poison ivy on the leg

      illustration

    • Erythema multiforme, circular lesions - hands

      Erythema multiforme, circular lesions - hands - illustration

      Erythema multiforme lesions are circular and may appear in concentric rings (often called target lesions). Target lesions may also be associated with other medical conditions such as herpes infection, streptococcal infection, tuberculosis (TB), or as a reaction to chemicals or medications.

      Erythema multiforme, circular lesions - hands

      illustration

    • Erythema multiforme, target lesions on the palm

      Erythema multiforme, target lesions on the palm - illustration

      Erythema multiforme lesions are often referred to as target lesions because of the concentric rings the lesions produce. The "target" appearance is well demonstrated in this photograph.

      Erythema multiforme, target lesions on the palm

      illustration

    • Erythema multiforme on the leg

      Erythema multiforme on the leg - illustration

      The red spots on this person's back appear where blisters (bullae) caused by Erythema multiforme have ruptured and the overlying skin removed (denuded). The resulting lesions are yellow-crusted ulcers (erosions). Erythema multiforme may be associated with herpes simplex infection, mycoplasma pneumonia, or other medical conditions such as streptococcal infection, tuberculosis (TB), or may result from exposure to chemicals or medications.

      Erythema multiforme on the leg

      illustration

    Self Care

     

      Tests for Rashes

       

         

        Review Date: 10/31/2016

        Reviewed By: Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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