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A rash is a change of the that 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, , become warm, bumpy, , dry, cracked or , 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 is an , , 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: Uncommon causes:


Conditions
Comedones, papules, pustules and nodules.Face, chest and back.
Acne Flushed appearance or redness.Cheeks, chin, forehead or nose.
Painful red bump or a cluster of painful red bumpsAnywhere
Red, tender and swollen areas of skinAround a cut, scrape or skin breach
Red and/or bumps on the skinAnywhere and can be sprinkled randomly
/ Expands over days or weeks to 5–70 cm (median 16 cm), circular or oval, red or bluish, may have an elevated or darker center, may have a central or ring-like clearing, may feel warm, not painful or itchy, , , on the , under clothing straps, or in children's hair, ear, or neck
Allergic reactionIrregular, raised or flat red sores that appeared after taking medicine/drugs or eating certain foodsAnywhere
Hidradenitis SuppurativaDeep sebum filled cystic condition of apocrine gland overstimulation, caused by many internal and external factors e.g., stress, toxic environmental overload and immune impairment.See Hidradenitis.
Bumps formed suddenlyAnywhere but usually first noticed on face
Seborrheic dermatitisBumps and swellingNear glands
Dry, scaly skinScalp of recently born babies
Irritant contact dermatitisRed, itchy, scaly, or oily rashEyebrows, nose, edge of the scalp, point of contact with jewellery, perfume, or clothing.
Allergic Contact Dermatitis caused by , poison oak, , or Balsam of PeruRed, itchy, scaly or oily rash; can also be weeping or leathery.Anywhere that came in contact with the irritant either directly or via transfer (e.g. from contaminated clothing.)
Small red dots on the skin, or larger, bruise-like spots that appeared after taking medicineAnywhere
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 tanChest and abdomen
Dermatitis herpetiformisIntensely itchy rash with red bumps and blistersElbows, knees, back or buttocks
Large red bumps that seem to bruise and are tender to touchAnywhere
White, scaly rash over red, flaky, irritated skinElbows and knees
Erythema multiformeRed, blotchy rash, with "target like" hives or sores.Anywhere
Red rash that is raised with a fever or sore throat.Usually starts first on the forehead and face and spreads downward.
Multiple blisters with a fever, cough, aches, tiredness and sore throat.Usually starts first on the face, chest and back and spreads downward.
Red blisters that are very painful and may crustAnywhere
Started as a fever and then developed a bright red rashCheeks
Soft bumps forming that do not itch and have no other symptomsAnywhere
Bald spot on the scalp or a ring of itchy red skinAnywhere
Rash that is red but not itchyPalms of hands or soles of feet
, or Red itchy rashGroin
Light coloured patchesAnywhere
Crusted, tan-colored soresNear nose or lip
Bite-like sores that itch and spread intenselyUsually start on hands or feet and spread everywhere
Rocky Mountain spotted feverA fine rash with a fever and headacheUsually start on arms and legs including the hands and feet
Lupus erythematosusA butterfly rash with achy jointsForehead and cheeks
or sign of YellowishSkin, whites of eyes and mouth
Blue or black area after being hitAnywhere
Actinic keratosesScaly, pink, gray or tan patches or bumpsFace, scalp or on the backs or the hands
or hypertrophic scarScar that has grown larger than expectedAnywhere
Soft or rubbery growthAnywhere
MiliaMany white spotsOn the face of a baby
or contagiosumSmall, firm, round bumps with pits in the center that may sit on tiny stalksAnywhere
Becomes confluent and forms bright red lines in the skin creases of the neck, armpits and groins (Pastia's lines)Face, chest and back, whole body, armpits, inside elbows, groins
Bump with a white dome under the skinScalp, nape of the neck or upper back
Soft, fleshy growth, lump or bumpFace, neck, armpits or groin
Yellow area under the skinUnder eyelids
Dark bump that may have started within a mole or blemish, or, a spot or mole that has changed in color, size, shape or is painful or itchyAnywhere
Basal cell carcinomaFleshy, growing massAreas exposed to the sun
Squamous cell carcinomaUnusual growth that is red, scaly or crustedFace, lip or chin
Kaposi's sarcomaDark or black raised spots on the skin that keep growing or have appeared recentlyAnywhere
Erythema annulare centrifugum (EAC)Pink-red ring or bullseye marksAnywhere


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, i.e. medications the patient is taking, the patient's occupation, where the patient has been and complete physical examination.

Points typically noted in the examination include:

  • The appearance: e.g., (typical of and meningococcal disease), fine and like sandpaper (typical of ); circular lesions with a central depression are typical of molluscum contagiosum (and in the past, ); plaques with silver scales are typical of .
  • The distribution: e.g., the rash of becomes confluent and forms bright red lines in the skin creases of the neck, armpits and groins (Pastia's lines); the vesicles of 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 , or , Scholar search guttate psoriasis, hand, foot and mouth disease, keratoderma blennorrhagicum);
  • Symmetry: e.g., usually only affects one side of the body and does not cross the midline.

A may be ordered, for diagnostic purposes.

(2009). 9780313378874, Abc-Clio. .


Treatment
Treatment differs according to which rash a patient has been diagnosed with. Common rashes can be easily remedied using steroid topical creams (such as ) 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.


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