Rashes

Alternative names:

erythema; rubor; skin lesion; skin rash; skin redness or inflammation

Home care:

FOR CONTACT DERMATITIS ONLY
Rash prevention is preferred to treatment. Avoid contact with clothing, cosmetics, deodorants, etc. that cause a rash.

Washing thoroughly with soap and water may remove chemicals on the skin and is particularly important with materials like cement dust. Oily substances can be removed with rubbing alcohol, or by paint thinner followed with a soap and water rinse to prevent contact dermatitis from the cleaner itself.

For rashes caused by poison ivy - Domeboro powder or tablets (available without prescription), hot water, and hydrocortisone cream to achieve relief from itching are recommended.

If skin is dry, avoid drying soaps and apply a heavy cream to skin after bathing.

Calamine and hydrocortisone may reduce itching.

Call your health care provider if:

• home treatment is ineffective, or if symptoms persist or worsen.
• other symptoms accompany the rashes.

What to expect at your health care provider's office:

The medical history will be obtained and a physical examination performed. Questions will be asked about recent exposure to various substances and the rash will be examined. A dermatologist is most qualified to deal with skin disorders.

Medical history questions documenting your symptom in detail may include:

• type of rash
  • Does it look like pinpoint red spots (petechiae)?
  • Does it look like small red areas (purpura)?
  • Does it look like bruises (ecchymoses)?
  • Has it occurred more than once without known cause (recurrent)?
  • Does it look like hives?
  • Does it look like blisters?
    • Are they filled with yellow or honey-colored fluid?

  • Does it look like ulcerations?
  • Does it look like dry, tough skin growth (keratosis)?
    • Is it associated with overexposure to sunlight (actinic keratosis)?

  • Is the rash scaling or crusting?
  • Does it look like small, solid, red, elevated bumps (papule)?
  • Does it look like both a macule (flat area) and papule (small bump)?
  • Is it a slightly elevated flat lesion (plaque)?
  • Does it have characteristics of acne rosacea?

• location
  • Does the rash cover the entire body or is it localized?
  • Where is it specifically?
  • Is it on the lower extremities?
    • Is it over the muscles that straighten the leg (extensor surfaces)?

  • Is it on the upper extremities?
    • Is it over the muscles used to straighten the arm (extensor surfaces)?

  • Is it on the genitals?

• distribution
  • Is the rash spreading to other areas?
  • Does the amount of skin area affected increase over time (enlarging)?
  • Is the number of skin lesions increasing over time?
  • Is it at the site of a skin injury (cut, scrape, etc.)?
  • Is it at a site of chronically damaged skin (e.g., burn)?
  • Do lesions affect only one side of the body (unilateral) or both (bilateral)?
  • Is the rash beginning on hands or feet (distal extremities)?
  • Have the sores gradually increased in size over months to years?
  • Are the lesions on exposed skin?
    • On sun exposed areas only?
    • Did the lesions begin at the site of an exposure?

• quality or color
  • Is the skin darkening (hyperpigmentation)?
  • Is the skin thickening?
  • Is the skin red (erythematous) or is it flesh colored?

• shapes and borders
  • Do the lesions have sharp, distinct borders?
  • Do they have a bulls eye appearance (irisated)?

• time pattern
  • Did the rash begin suddenly (within hours) or slowly and gradually?
  • How long did the rash last?
  • Are there short-lasting episodes of rashes (transient)?
  • Does the same type of rash occur repeatedly (recurrent)?
    • How often does the rash occur?

  • Did symptoms begin at birth or in infancy?
    • At what age?

  • Has the rash been long standing (chronic)?
  • Did symptoms begin after a fever occurred and was relieved?
  • Which months does the rash usually occur during?
  • Did you have a vesicle that disappeared after a number of weeks? How many?

• aggravating factors
  • Is it worse after taking a bath (or other exposure to water)?
  • Is it worse when you are stressed?
  • Does it occur after cold exposure?
  • Is it worse after you use skin softening or smoothing agents (emollients)?
  • Is it worse after an exposure to the sun?

• relieving factors
  • Does the rash get better after you use skin softening or smoothing agents?

• changes over time
  • Did you have red cheeks followed within 2 days by a red spotty rash?
  • Was the rash of a brief duration and then went away (evanescent)?
  • Did the lesion change from a vesicle to an ulcer?
  • Did the lesion change from an indurated nodule to a "beefy" red ulcer?

• other
  • What other symptoms are also present?
  • Is there itching?
  • Is there pain?
  • Is there drainage? What kind?

Diagnostic tests that may be performed include:

• skin biopsy
• blood tests (if indicated)

Intervention:
Steroid creams may be prescribed (see Corticosteroids - topical - medium to very high potency). Other interventions will depend on the type and cause of the rash.

After seeing your health care provider:
You may want to add a diagnosis related to a rash to your personal medical record.