A rash is a change of the skin which affects its color, appearance, or texture. A rash may be localized in one part of the body, or affect all the skin. Rashes may cause the skin to change color, itch, become warm, bumpy, chapped, 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 diagnosis may confirm any number of conditions. The presence of a rash may aid diagnosis; associated signs and symptoms are diagnostic of certain diseases. For example, the rash in measles is an erythematous, morbilliform, maculopapular rash that begins a few days after the fever starts.
It classically starts at the head, and spreads downwards. Differential diagnosis Common causes of rashes include: Food Allergy Anxiety Allergies, for example to food, dyes, medicines, insect stings, metals such as zinc or nickel; such rashes are often called hives. Skin contact with an irritant Fungal infection, such as ringworm Balsam of Peru Reaction to vaccination Skin diseases such as eczema or acne Exposure to sun or heat Friction due to chafing of the skin Irritation such as caused by abrasives impregnated in clothing rubbing the skin. The cloth itself may be abrasive enough for some people Menstruation Secondary syphilis Poor personal hygiene Uncommon causes: Autoimmune disorders such as psoriasis Lead poisoning Pregnancy Repeated scratching on a particular spot Lyme Disease Scarlet fever Diagnostic approach The causes of a rash are numerous, which may make the evaluation of a rash extremely difficult. An accurate evaluation by a provider may only be made in the context of a thorough history and complete physical examination.
Points to note in the examination include: The appearance: e.g., purpuric, fine and like sandpaper; circular lesions with a central depression are typical of molluscum contagiosum; 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; the vesicles of chicken pox seem to follow the hollows of the body; very few rashes affect the palms of the hands and soles of the feet; Symmetry: e.g., herpes zoster usually only affects one side of the body and does not cross the midline. A patch test may be ordered, for diagnostic purposes. Overview of symptoms Treatment Treatment differs according to what rash a patient has been diagnosed with.
Common rashes can be easily remedied using steroid topical creams or non-steroidal treatments. Many of the medications are available over the counter in the United States. The problem with steroid topical creams i.e. Hydrocortisone; is their inability to penetrate the skin through absorption and therefore not be effective in clearing up the affected area, thus rendering the hydrocortisone almost completely ineffective in all except the most mild of cases.
See also List of cutaneous conditions Dermatology References External links Guide to rashes on Medline Plus Medical Encyclopedia – includes photographs Links to pictures of skin rashes Pictures of common skin rashes compared Arm Pit Rashes.
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