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Rashes



A rash is an area of irritated or swollen skin. Many rashes are itchy, red, painful, and irritated. Some rashes can also lead to blisters or patches of raw skin. Rashes are a symptom of many different medical problems. Other causes include irritating substances and allergies. Certain genes can make people more likely to get rashes.


Because rashes can be caused by many different things, it's important to figure out what kind you have before you treat it. If it is a bad rash, if it does not go away, or if you have other symptoms, you should see your health care provider. Treatments may include moisturizers, lotions, baths, cortisone creams that relieve swelling, and antihistamines, which relieve itching.




rashes



There are two main types of birthmarks: pigmented, spots of skin that contain extra pigment (color); and vascular, which contain extra blood vessels that didn't fully form. Both types are usually harmless, and some go away on their own. But some need to be watched to make sure they don't cause problems. Be sure to talk with your pediatrician about any birthmarks or rashes you notice on your baby.


To the untrained eye, all rashes may look alike and seem easily treatable with over-the-counter oral antihistamines or hydrocortisone cream. However, it is not always so simple, say dermatologists. Rashes can appear as blotches, welts, or blisters; they can be red, itchy, scaly, or dry; and they can occur in one area of skin or all over the body. In addition, some rashes may come and go, while others never seem to go away.


Although most rashes are not life-threatening, some rashes can signal something more serious. If you have a rash and notice any of the following symptoms, see a board-certified dermatologist or go to the emergency room immediately:


You have a fever with the rash. If this is the case, go to the emergency room. This could be caused by an allergic reaction or an infection. Examples of rashes caused by infection include scarlet fever, measles, mononucleosis, and shingles.


But some rashes, especially combined with a fever, can be signs of serious illnesses. Hives, also called urticaria (say: ur-tuh-KAR-ee-ah), also can be serious because they can be a sign of an allergic reaction and the person may need immediate medical attention.


Some rashes form right away and others can take several days to occur. When a rash appears, you usually know it because it will start to bother you. If you develop a rash, tell a parent or another adult as soon as you can. For instance, you might want to see the school nurse if you are at school.


A visit to the doctor is a good idea if you have a rash. Although all rashes may look alike to you, your doctor or a dermatologist (say: dur-muh-TOL-uh-jist), a skin doctor, knows the difference. And knowing which kind of rash you have can help the dermatologist choose the best treatment to heal your rash.


For rashes that are caused by an allergen, including hives, the doctor will probably want more information. He or she will want to find out which food, substance, medicine, or insect caused your rash or hives. The doctor might recommend a medical test to determine which allergens are causing you trouble. It's important to find this out because the best way to prevent rashes and hives caused by allergens is to avoid the problem food, substance, medicine, or bug.


Infections that involve bacteria, viruses, fungi, or parasites can also cause a rash. These rashes will vary depending on the type of infection. For instance, candidiasis, a common fungal infection, causes an itchy rash that generally appears in skin folds.


Other causes of rashes outdoors include hay fever (seasonal allergy) and exposure to poison ivy and other plants. If a person has a skin reaction to pollen, poison ivy, a jellyfish sting, brown-tail moth caterpillars, and other plants or animals, a doctor may refer to it as contact dermatitis.


Measles rashes: Measles is a representative infectious disease with a skin rash. The rash starts from behind the ears and progresses to the face, followed by the neck, torso, and extremities over the course of 2-3 days. The disease shows a characteristic course in that the fever disappears when the rash stops evolving. Measles appears as a diffuse macular rash at the outset, followed by a rash with a papular morphology, and gradually develops into a morbilliform, or typical systemic maculopapular rash. The rash starts to disappear from the face, and residual brown skin pigmentation may appear in areas where the rash has faded. Disappearance of the rash may be accompanied by dry desquamation. In addition, Koplik spots (enanthem) appear either 12 h before or within 24 h of rash appearance [10].


Rubella: The rash in rubella, like measles, also progresses from the face to the body. However, progression is complete within a few hours, which is much faster than measles, and the rash has a lighter color. Although it is not easy to differentiate the rash from measles within 24 h of onset, the rash fades within 2-4 days, which is faster than measles, with no residual skin pigmentation after fading of the rash. However, desquamation can be seen, as in measles. Although lymph node enlargement may be seen behind the ears or below the occiput in rubella, this finding is nonspecific, and is not essential for diagnosis. Since rubelliform rashes occur during the evolution of various viral diseases, rubella can be diagnosed only by the overall clinical course [4,10].


Erythema infectiosum: This is an exanthematous disease that is caused by human parvovirus B19 [12], and is characterized by an erythematous or elevated rash, as if the patient had been struck on both cheeks; it gradually evolves to a papular rash after appearance of a macular rash at the margins of the extremities and on the buttocks. These rashes persist for a while, and then start to fade from the middle of the 6th day, take on an appearance like lace, and disappear on the 7th-9th day after the first appearance of the rash. However, sometimes the rash may recur after a few weeks. Infectious erythema, unlike measles, rubella, and roseola, does not occur in infants, but mostly in school-aged children.


Enteroviral infection: Rashes caused by enteroviruses show highly diverse patterns, including maculopapular petechiae and urticaria; since progression of the rashes varies, they are not clinically specific. However, these diseases may be considered when a rash appears in a clinical context; it should be noted that ECHO virus (particularly type 9) can frequently cause petechial rashes [4].


Acute infectious mononucleosis: When pediatric patients with this disease receive β-lactam antibiotics, especially semisynthetic penicillin-derivatives, 50-100% will develop speckled or maculopapular rashes that spread systemically and last 2-7 days. In these cases, the rashes clearly appear on the torso and proximal extremities. These pediatric patients have fever for several days, but the rashes could provide complementary diagnostic information when there are clinical findings of infectious mononucleosis, including pharyngitis, lymphadenitis, and enlargement of the liver or spleen [10].


Gianotti-Crosti syndrome: This is an exanthematous disease that is associated with hepatitis B or other viral infections, although the etiology is unclear [13]. A systemic rash occurs in association with fever and lymph node enlargement. The rashes are mostly papular, showing a characteristic concentration over the face and extensor musculature of the extremities, and last for 3-4 weeks.


Scarlet fever: Scarlet fever is a typical maculopapular exanthematous rash due to a bacterial infection. It is the characteristic rash caused by the erythrogenic toxin of streptococcus at the onset of disease [22]. Specifically, after prodromal symptoms of pharyngitis for 2-3 days, a minute papular rash starts in the axillary region and inguinal area, and proceeds around the neck and the back, ultimately spreading to the entire body. It is particularly distinct in skin folds, resembles sunburn, and feels warm and dry. Since measles and rubella sometimes show similar rashes, they need to be differentiated from scarlet fever. The primary characteristic differentiating scarlet fever from measles and rubella is that there are no rashes or clear findings of upper respiratory inflammation, except that the area around the mouth becomes pale and both cheeks are red. Another difference in scarlet fever is the appearance of Pastia lines, with linear petechial hemorrhages in which erythema does not disappear when the axillary region, inguinal area, and antecubital fossa are compressed. However, scarlet fever, like measles and rubella, also shows desquamation, which appears one week after the onset of disease and persists for several weeks.


Disseminated gonococcal infection; When gonococcal infection is hematogenously disseminated, resulting in rapid progression, papular rashes, petechiae, and hemorrhagic folliculosis appear mostly on the torso, but also systemically. Neisseria gonorrhoeae can be detected in these skin lesions [4].


Mycoplasma infection; Mycoplasma infection shows epidemiological characteristics that suddenly appear in multiple locations every 3-4 years, with maculopapular, urticaria-like, and papular rashes in the entire body in about 30-50% of cases, along with symptoms of upper and lower respiratory tract infection, and central nervous system symptoms. However, since these rashes are nonspecific, they do not lead to a diagnosis. Nevertheless, when mycoplasma infection is prevalent and there are clinical manifestations suspicious for this infection, a rash could be helpful diagnostic information.


Representative diseases with noninfectious systemic maculopapular rashes include exanthematous and collagen-vascular diseases due to hypersensitivity reactions. Exanthematous diseases caused by a hypersensitivity reaction that are commonly seen clinically include erythema toxicum of the newborn, urticaria, erythema multiforme, drug eruptions, and pityriasis rosea [23]. On the other hand, since all collagen-vascular diseases such as rheumatic fever, rheumatoid arthritis, and lupus erythematosus show highly characteristic clinical symptoms, occurrence of rashes can provide further evidence for the diagnosis, even though the rash itself is nonspecific. 2ff7e9595c


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