Rash is an impermanent eruption or discoloration of the skin. It is frequently inflamed or swollen. Rashes occur in various forms and levels of harshness, and they persist for different amounts of time. Some widespread causes of rashes are:
* Infections — This wide category includes a broad range of diseases, such as:
o Viral infections, including: measles, rubella, roseola, fifth disease, varicella zoster, herpes or shingles
o Bacterial infections, including impetigo, scarlet fever or Lyme disease
o Fungal infections, including jock itch (a fungal infection in the groin region)
o Lots of others
* Various allergic reactions — They may be activated by:
o Medicines such as antibiotics, seizure medicines and diuretics
o Topical skin products, including cosmetics, perfumes or skin creams
o Foods, particularly peanuts, seafood and eggs
o Insect stings (such as bees, wasps and hornets)
* Local irritants — This category comprises diaper rash (caused by prolonged skin contact with urine and stool) and rashes resulting from contact with harsh chemical substances, such as laundry soaps and fabric softeners.
* Poisonous plants — Poison ivy, poison oak and poison sumac share an enormously allergenic sap resin that may bring about allergic rashes in 70 per cent of people exposed to it.
* Autoimmune conditions — This category involves: systemic lupus erythematosus (SLE or lupus), dermatomyositis and scleroderma, conditions in which the body’s immune defenses mistakenly attack healthy areas of the body, including the skin.
Symptoms of Rash
Even though rash is very easy to identify, each rash appears to be very different. Rashes differ in their appearance, timing, location, distribution, and duration. Generally, we may describe rashes as:
* Macular — Flat, red spots
* Papular — Small, raised, solid bumps
* Macular and papular — A combination of the above two
* Papulosquamous — A combination of papules and scaly areas
* Vesicular — Small, raised, fluid-filled blisters
Supplementary signs and symptoms that sometimes appear along with the rash include:
* Fever
* Swollen lymph nodes (swollen glands)
* Signs of a serious allergic, potentially life-threatening reaction known as anaphylaxis, which requires instant emergency medical help: problems with breathing, hives, vomiting, abdominal cramps, rapid decrease of blood pressure, confusion and unconsciousness
* Symptoms of an autoimmune disorder, such as lupus (may include fatigue, poor appetite, fever, joint swelling) or dermatomyositis (frequently involves weak muscles, swelling and violet discoloration of the eyelids and difficulty rising after sitting)
Diagnosis
Your healthcare provider will obviously ask you about your medical history, along with your history of allergies and your work history, in order to check for possible exposure to chemical irritants or to individuals with infections. Furthermore, your physician may ask detailed questions about your rash, such as:
* When it started — Did the rash occur after you consumed a new food, tried new skin care cosmetics or took some new medicines?
* Location and pattern — Does the rash strike only sun-exposed areas or only those in direct contact with gloves, shoes, goggles or face masks (as would be expected with allergic reactions to a chemical in the item)? Does it mold a "butterfly" pattern over the cheeks and nose (a classic symptom of lupus), or does it bring about a bright red "slapped cheek" pattern (a symptom of fifth disease)?If you like trekking, does it form linear streaks along the lower legs (a sign of poison ivy)?
* Duration — Did the rash occur and vanish within a day or two (as in roseola), or has it persisted for a week (as in fifth disease) or more (as in SLE)?
* Occupational exposures — Are you perhaps a day care worker who may be exposed to children experiencing rash-producing diseases (measles, rubella, roseola, fifth disease)? Do you work or play in the wooded areas where there is an elevated risk of tick bites?
Your healthcare provider may suspect a particular cause rooted in your medical history and the history of your rash. Your physician will try to acknowledge this speculation by evaluating the rash’s appearance, location, pattern and any related symptoms. In many cases, the findings of your physical exam will elucidate the diagnosis, and further tests will not be necessary.
If necessary, other tests or examinations may include:
* Blood tests — Even though the majority of viral rashes do not need precise identification of the virus, blood tests are obtainable to recognize some viruses and bacteria causing rash-producing infections. Blood tests may also be performed to check for autoimmune disorders.
* Patch tests — If your healthcare provider suspects a local allergic reaction, he or she may perform skin tests known as patch tests. In the course of these tests, little amounts of various chemical substances are placed on your skin for two days in order to find out if an allergic rash develops.
* Wood’s lamp — A Wood’s lamp is a black light used for the evaluation of rashes. The light may make the influenced area of skin glow red, pale blue, yellow or white. Everything depends on the exact cause of the rash.
* Tzanck test — In this test, a blister is opened and scraped in order to gain a sample that is analyzed in a laboratory for the symptoms of herpes virus infection.
* KOH preparation — In this test, an area of the skin that is suspected by the physician of having a fungal infection is scraped softly Scraped material is placed on a slide, treated with KOH (potassium hydroxide) and then analyzed under the microscope for signs of fungi.
* Skin biopsy — In the course of this procedure, the skin is numbed and a sample of infected skin is removed and analyzed in a laboratory. Stitches may be necessary.
Expected Duration
How long a rash persists is always dependent on its cause. Nevertheless, the majority of rashes normally go away within several days. For instance, the rash of a roseola viral infection normally persists 1 to 2 days, while the rash of measles goes away within six to seven days. Rashes resulting from an antibiotic allergy may persist 3 days to two weeks, while diaper rash almost always clears up within one week (if diapers are altered very often).
Rashes resulting from lupus or dermatomyositis can go on for an extended period of time.
Prevention
Prevention is dependent on the cause of the rash:
* Infections — Make sure that you and your kids are up-to-date in your regular immunizations. Wash your hands as often as possible, have a regular bath or shower and try not to share clothing or personal grooming items with other people. In order to prevent Lyme disease, wear light-colored clothing contrasting with the dark tick and covering most of your skin when you go into the woods. Use only approved tick repellents. Be aware that you are more prone to be exposed to ticks in areas of the country where Lyme disease is widespread.
* Allergic reactions — Avoid the particular food, medications, skin care products or cosmetics that you didn’t have response to. Do not take any medication prescribed for somebody else.
If you suppose that you are allergic to insect stings, consult your healthcare provider immediately. You might visit an allergist for testing and possible desensitization therapy. Moreover, you may require a bee-sting kit containing emergency medicines to prevent potentially life-threatening reactions. Be sure that you know where the kit is located at home and think about getting an additional one if you frequently take part in an outdoor sport. Keep the second kit in your sports bag.
* Local irritants —For diaper rash, alter diapers immediately after they have become wet or soiled. Be sure that your baby’s bottom is carefully clean and dry before closing up the fresh diaper. For sensitivity to chemicals in cleaning products, substitute the chemicals you use with laundry soaps and fabric softeners that are free of dyes and perfumes. For irritation caused by cosmetics, use hypoallergenic products containing not so many skin-irritating preservatives and fragrances.
* Poisonous plants — Find out how to identify poison ivy, poison oak and poison sumac. If you are a hiker and you like to trek in the forests or do yard work, always cover exposed arms and legs with long-sleeved shirts and long pants.
Treatment
Treatment is dependent on the cause of the rash:
* Infections — Bacterial infections are normally treated with antibiotics. Fungal infections are treated with antifungal medicines. A lot of viral infections causing rash will disappear within a few days and do not require any medicines. Less frequently, antiviral medications are needed.
* Allergic reactions — A serious allergic reaction is a life-threatening medical emergency. It needs to be treated instantly with epinephrine, a medicine opening narrowed airways and increasing hazardously low blood pressure. High doses of corticosteroids and antihistamines are also used in order to suppress the reaction of immune system’s. Localized allergic reactions may be treated by means of topical or oral corticosteroids, antihistamines and ice to alleviate the itching and swelling.
* Local irritants — Diaper rash can be treated by changing diapers very often and using nonprescription creams or ointments containing zinc oxide and mineral oil.
* Poisonous plants — The skin ought to be flushed carefully with warm water in order to get rid of the allergenic substance. Only then ought you to lather with soap and water. If you use soap promptly before flushing the skin with water, you are prone to spread the allergenic plant oil over your skin. When you have washed off the oil, it can’t spread. It frequently happens that the rash is treated with prescription topical steroid medicines. Nevertheless, oral steroids may be necessary for extensive rashes or rashes on the face.
* Autoimmune disorders — These diseases can be treated with corticosteroid and immunosuppressive medications, medicines suppressing the patient’s overactive immune system.
When To Contact A Specialist
Ask for instantaneous medical attention if you start to experience difficulty breathing or develop hives, a fever, a fast pulse, confusion or nausea. These could constitute the symptoms of a life-threatening allergic reaction.
Always talk to your healthcare provider immediately if a rash:
* Becomes worse
* Persists more than one week
* Demonstrates signs of local infection (oozing, redness or swelling of the skin)
* Is followed by fever, chills, swollen glands or other symptoms of infection (sore throat, cough, headache, nasal congestion, etc.)
* Appears along with symptoms indicating an autoimmune disorder, such as recurring fever, malaise, tiredness, unexplained weight loss or joint swelling
Prognosis
The outlook for the majority of rashes is brilliant, particularly after the cause has been recognized precisely.
In case of serious allergic reactions, a patient may die within several minutes without prompt medical attention. With appropriate treatment, recovery is normally complete. Nevertheless, the patient is still at high risk of future serious reactions if he or she is exposed to the same allergy-producing factor. Due to this reason, a prescription for a self-injection pen containing epinephrine for emergencies is normally suggested for patients suffering from severe allergies.
For long-lasting autoimmune disorders, rash is the only one of a broad variety of symptoms. The prognosis is dependent on the kind and severity of the autoimmune disease.
