Rash
What is Rash?
The term “rash” does not refer to a specific disease or disorder. It’s a colloquial term that indicates red and itchy bumps (scaly patches or cutaneous eruptions) on the body which change the appearance and texture of the skin. Other names for this ailment are Dermatosis or Skin Rash, in which skin eruptions or rashes are prominently visible. Rashes can be localized to one area of the skin or spread over a large area.
Symptoms of Rash
A person suffering from skin Rash would experience one or more of the following symptoms:
01) Itchy scalp
02) Sensitive Skin to Touch
03) Painful skin
04) Pinprick red dots on skin
05) Skin blisters
06) Joint and muscle pain
07) Chronic hives
08) Redness of face and body
09) Non-stop itching of affected area
10) Swelling in the affected area.
Diagnosis of Rash
For accurate diagnosis and treatment, after a thorough physical examination, the dermatologist needs to ask some questions to assess the kind of infection and its severity, for example:
1) How long the rash has been present – this is to determine whether it is an acute (one time occurrence) or chronic (persistent and long-term) problem.
2) Where is the rash and which part of the body did it occur first – this is to determine the probable cause.
3) Fever and contact with anyone else who has rash – to gauge if it is contagious.
4) Medical history of skin disorders – like asteatosis (dry skin) or diabetes.
5) Recent use of new clothing – to determine allergies.
6) Are nails affected – suggesting psoriasis or tinea.
A) Diagnosis of rash by its appearance:
1) A macular or papular rash may suggest eczema, exfoliative dermatitis, pityriasis rosea, drug reaction or contact dermatitis;
2) A pustular rash may suggest staphylococcus, fungal skin infection or scabies;
3) A vesicular rash would indicate impetigo, contact dermatitis, eczema or even chickenpox;
4) Psoriasis, ichthyosis, exfoliative dermatitis, lichen planus, fungal skin infection etc would appear as a scaly rash;
5) Basal cell carcinoma (cancer) appears as an ulcerative rash.
B) Diagnosis of rash by the percentage of skin affected:
A focal rash (in a specific area of skin) would indicate fungal skin infection, contact dermatitis, scabies, eczema, skin tumor or impetigo; whereas a widespread rash would be indicative of psoriasis, drug eruptions, pityriasis rosea, lichen planus, dermatitis herpetiformis, etc.
C) Diagnosis of rash by the location:
If the rash is focal, the dermatologist would then see what areas of the body are primarily involved. If the rash is on the extremities atopic dermatitis, tinea, psoriasis or insect bites is the usual diagnosis. If it is on lower leg then it would indicate necrobiosis lipoidica, keratitis pilaris, stress dermatitis or nummular dermatitis. And if the rash is the outer skin surface of the knees then it would indicate psoriasis and dermatitis herpetiformis.
Causes of Rash
Note: Although foods, soaps, and detergents are often blamed for widespread rashes, they are rarely the culprits. The various probable causes of rashes are:
Heredity: There are certain rashes which have a genetic cause (like exzema or atopic dermatitis). Another close family member would probably have similar skin ailments.
Medications: Certain medications like Dextrothyroxine Sodium, Choloxine, Daunorubicin Hydrochloride, Cerubidine and Rubilem, used to treat other diseases can cause allergic reaction.
Allergies of substances: This is one of the most common reasons for rashes. People can be allergic to a number of things that might cause rashes like eggs, peanuts, wheat, milk, soybean, fish, poison ivy, latex, etc.
Diseases/Infections: Other diseases like Impetigo, Chicken pox, Measles, Fungal infections, Athlete’s foot, Meningococcal disease, etc cause rash.
Parasitic conditions: Certain parasites cause rashes like Scabies and Lice conditions.
Other causes: Systemic conditions can cause rashes like Lupus.
Caution: The rash caused by Meningococcal disease, which is a hemorrhagic rash with bleeding of capillaries just under the skin is not a very common rash but greatly feared.
Types of Rash
The rashes can be categorized by their causes but the broad groups are:
A) Atopic dermatitis: Atopic Dermatitis is perhaps the most common form of rash. The term “atopic dermatitis” literally means “allergic inflammation”. It is a hereditary skin problem that usually begins in early childhood.
B) Contact dermatitis: Contact dermatitis is a rash that is brought on by skin-contact with an allergy-causing material like too-frequent hand washing; contact with poison ivy; reactions to nickel-based costume jewelry; recent use of new clothes, etc.
C) Fungal rashes: Yeasts are botanically related to fungi and can cause skin rashes. These tend to affect folds of skin (like the skin under the breasts or the groin). They look fiery red and have pustules around the edges.
D) Bacterial rashes: The most common bacterial infection is impetigo, especially so in children, is caused by staph or strep germs. Again, poor hygiene plays little or no role.
E) Viral rashes: Except herpes or shingles which are localized to one part of the body, viral rashes are normally symmetrical and widespread. A viral rash usually subsides on its own after a few days. Patients may not necessarily have other viral symptoms like nausea, sneezing, fever or cough.
F) Allergic drug rash: Most allergic drug rashes start within two weeks of taking a new medication. To confirm, the medication is stopped for a while. If the rash doesn’t disappear within five days of stopping the medication, allergy is unlikely.
G) Other rashes: Hives (urticaria) are itchy, red welts that come and go on various parts of the body. Most hives are not allergic, run their course, and disappear as mysteriously as they came.
Treatment of Rash
If the rash is mild and focal, just non-prescription remedies which are available over the counter (OTC) are sufficient to treat the ailment. This would include: anti-itch creams containing camphor, menthol, pramoxine, a diphenhydramine; antihistamines like diphenhydramine, chlortrimeton, or loratadine; and moisturizing creams or lotions. If the rash persists or spreads more widely other modes of treatment are employed by the dermatologist:
Atopic dermatitis: Treatment of atopic dermatitis (allergic rash) involves minimizing irritation if that is contributing to the problem and using prescription-strength steroids (cortisone creams). Tap water soaks with Burrow’s solution (available without prescription) can help dry up atopic dermatitis in its oozing stages.
Contact dermatitis: Treatment of contact dermatitis involves avoiding the allergen that caused it, if there is one, or minimizing whatever exposure is irritating the skin (water on the hands, solvents at work, saliva around the mouth from lip licking, etc). Effective over-the-counter treatments are available like topical steroids contaning1% hydrocortisone and many prescription-strength creams. Tap water soaks with Burrow’s solution cab help dry up oozy contact dermatitis as well.
Fungal rashes: Treatment of fungal rashes is usually straightforward. Many effective antifungal creams can be bought over-the-counter without a prescription, including those containing 1% clotrimazole or 1% terbinafine.
Living with Rash
Most rashes are not dangerous to the patient or to people in the vicinity, except in the case of rashes involved with infectious diseases like chickenpox, measles, etc. Many rashes last a while and get cured on their own. It is therefore not unreasonable for a person to self-treat symptoms like itchy and / or dry skin for a few days to see whether the condition reduces in intensity or gets cured altogether. Despite their reputation, fungal rashes are not commonly caught from dogs or other animals, nor are they easily transmitted in gyms, showers, pools, or locker rooms. In most cases, they are not highly contagious between people either.
Prevention of Rash
Most rashes will improve with gentle skin care and avoiding contact with substances causing irritation. There are some measures that can help to prevent the ailment of rashes:
1) Use of gentle shower gels and cleansers instead of soaps
2) Minimize or avoid use of body scrubs and loofahs (bath sponges)
3) Use warm water (not too hot) for washing and bathing
4) Pat-dry the skin, don’t rub it harshly with the towel
5) Avoid using cosmetics you have never tried and tested
To prevent existing focal rash from spreading:
1) Apply calamine lotion on the affected area
2) Leave the affected area exposed to air instead of covering with cotton
3) Eliminate any newly added cosmetics, creams, lotions, shampoos, soaps, scrubs, etc.
Caution: People with atopic dermatitis or eczema should not be vaccinated against smallpox, whether or not the condition is active. In the case of other rashes, the risk of complications is much less. Consult your doctor about the smallpox vaccine.
