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Is That Rash Psoriasis? Psoriasis Pictures and More
Psoriasis is an autoimmune disease thought to be caused by an immune system dysfunction. If you have psoriasis, your immune system sends signals to your skin that speed up the production of skin cells. While there are signs and symptoms that set the disease apart from other conditions affecting the skin, it isn’t always easy to distinguish it at first.
About 7.5 million people in the United States have psoriasis, which causes itchy, scaly patches of thick, red, dry skin called plaques. Psoriasis plaques can consist of a few spots of dandruff-like scales or major eruptions that cover large areas. While the disease can affect any part of your body, it most often surfaces on the scalp, elbows, knees, back, face, palms, and feet.
There are five types of psoriasis — plaque psoriasis, guttate psoriasis, pustular psoriasis, inverse psoriasis, and erythrodermic psoriasis — none of which is contagious. Each type causes a different skin rash and can appear on different areas of the body. Plaque psoriasis, also known as psoriasis vulgaris, is the most common type. As many as 90 percent of people with psoriasis have this form. Guttate psoriasis is the second most common type. Far less common is pustular psoriasis, which is characterized by pus-filled bumps known as pustules, and erythrodermic psoriasis, a very serious form of the disease that affects about 3 percent of people with psoriasis.
It’s unclear what exactly causes psoriasis, though genetic factors have a lot to do with whether you’ll develop the chronic skin condition.
Psoriasis symptoms typically respond to treatment. Most psoriasis therapies aim to stop skin cells from growing so quickly and to smooth out the skin. But the disease may never go away completely, and it tends to come back. Treatment options can include topical corticosteroids and biologic drugs. Another option is light therapy, or phototherapy, in which targeted light rays are delivered to the skin.
Because psoriasis can look like other skin conditions that cause scaly patches and itchy rashes with inflammation, it is often confused with various disorders. These may include common skin conditions such as acne, eczema, or heat rash. Psoriasis can also resemble and be confused with the fungal infection known as ringworm.
Most of the time, psoriasis can be diagnosed with a physical examination. However, a skin biopsy may be needed to rule out other possibilities and arrive at a definitive diagnosis.
Do you know how to spot psoriasis symptoms? Here are some things you can look out for.
(The images that follow are of real medical conditions and may, in some cases, be graphic.)
A skin rash is a common side effect of certain types of cancer treatments. Cancer treatments that can cause skin rash may include chemotherapy, radiation therapy, immunotherapy, targeted therapy, and stem cell transplant.
Skin rashes can show up on the scalp, face, neck, chest, upper back, and sometimes on other parts of the body. Rashes can itch, burn, sting, or be painful. They usually develop within a few weeks of receiving the treatment, but can develop at any time during your cancer treatment.
It’s important to know that a skin rash that is an expected side effect of treatment is not considered an allergy or allergic reaction. However, just like any medicine, people can have allergies to chemotherapy, immunotherapy, and targeted therapy drugs.
A skin rash that develops suddenly while you are receiving a drug used to treat cancer could be a sign that you are allergic to that drug.
Some common types of rashes experienced by patients receiving treatment include:
- Papulopustular eruption: This is a rash that may be itchy and painful and commonly occurs on the chest, upper back, or face. It is common in patients who receive certain treatment drugs.
- Radiation dermatitis: This is a rash that develops in patients receiving radiation therapy. It usually occurs in the area of the skin getting radiation. It may be mild or severe depending on the location of the radiation, how much skin was affected, total radiation dose, and how long the radiation is given.
- Radiation recall: This is a rash that develops in an area of the body that has previously had radiation therapy. It sometimes happens when a person receives chemotherapy or targeted therapy drugs
after completing radiation therapy.
- Hand-foot syndrome:Certain patients may develop this condition, which causes redness, swelling, pain, and sometimes tingling in the palms of the hands and soles of the feet.
Talk to your cancer care team about the treatment you are receiving and if you are at risk of developing a skin rash. Let your doctor know if you notice any rash, big or small.
What the patient can do
- Talk to your cancer care team about your rash and what they recommend to help the rash get better. Your cancer care team may recommend mild soaps, lotions, and moisturizers. In certain cases, your doctor may prescribe medication to help with the rash.
- Clean the skin gently with warm water, gentle soap, and a soft cloth
- Rinse the rash area carefully and pat dry
- Keep your skin moisturized
- Protect the affected area from heat and cold
- Stay out of the sun as much as possible, because sunlight seems to trigger and/or worsen rashes in some people. If you’ll be outside during the day, wear a hat and clothes with long sleeves. Use a broad-spectrum sunscreen with SPF of at least 30 and zinc oxide or titanium dioxide at least 1 hour before going out. Be careful near windows too.
- Wear loose-fitting, soft clothing.
- Apply medicines prescribed for skin reactions.
- Protect all of your skin from the sun. For instance, wear a wide-brimmed hat, sunglasses, and long-sleeved shirts when outside.
What caregivers can do
- Keep track of any new drugs, soaps, detergents, or foods that might have caused a rash
- Help the patient apply medications and creams to areas they can’t reach
Call the cancer care team if the patient
- Has a rash that gets worse after creams or ointments have been used
- Has itching that does not go away after 2 or more days
- Scratches skin until it’s open or bleeding
- Has a rash that is uncomfortable and keeps them up at night
- Has blisters, bright red skin, or crusts on the skin
- Has foul-smelling drainage or pus coming from the skin
- Develops yellowish skin or has urine the color of tea
What’s That Rash? | GoHealth Urgent Care
No one wants to scratch an itch only to discover that a red, bumpy rash has cropped up, but the truth is that we’re all bound to get a rash at some point or another.
Luckily, rashes are common occurrences and can be treated relatively easily with the right knowledge and care.
Here, we’ll show you some of the most common types of rashes, how you may be able to treat them at home and when you should see a doctor.
Most Common Rashes
Here are some of the most common types of rashes and what they look like:
Atopic dermatitis, also known as eczema, is a non-contagious skin condition that’s characterized by itchy, red and dry skin. According to the National Institute of Allergy and Infectious Diseases (NIAID), eczema affects nearly 30 percent of the U.S. population.
Source: Everyday Health
Unfortunately, eczema isn’t curable, but it is treatable. For many, the most effective short-term treatment is applying an anti-itch cream or a rich moisturizer and/or taking an oral allergy medication.
For eczema sufferers who can’t find relief through at-home methods, more powerful prescription topical and oral medications exist, such as hydrocortisone cream and Diphenhydramine (Benadryl), respectively.
If the patient’s affected skin has contracted a secondary infection, antibiotics may also be necessary (click here to learn more about antibiotics and when they should and shouldn’t be used).
Poison Ivy, Poison Oak and Sumac Rashes
Poison ivy, poison oak and sumac are plants that can cause redness, blotchy spots, itching, blisters and/or swelling upon contact.
According to Mayo Clinic, poison ivy, poison oak and sumac rashes are caused by uroshiol, an oily resin that coats the plants.
Although washing your skin immediately after exposure can help reduce your risk of getting a rash, the uroshiol’s oily nature can make it difficult to wash off.
Over-the-counter washes designed to target uroshiol can be purchased at drugstores, but if you’re not able to use such a wash before the rash sets in, there’s little you can do besides treating the worst of the rash’s symptoms.
To soothe poison ivy, poison oak and sumac rashes, many turn to non-prescription anti-itch creams, which can help reduce itching. Other home treatments include cold compresses and oatmeal baths.
People with severe rashes, blistering and swelling should see a medical provider and may be prescribed with a topical treatment.
Unlike superficial rashes, scabies is caused by microscopic burrowing mites that infest and lay eggs in the outer layers of the skin.
According to the Centers for Disease Control and Prevention (CDC), scabies is usually spread through skin-to-skin contact with infected persons. Its most common symptoms are severe itching and a pimple-like rash, though tiny burrows can sometimes be seen with the naked eye.
Scabies is far from uncommon — the American Academy of Dermatology states that there are millions of cases worldwide each year.
Scabies mites can live for up to two months in a person’s skin, so scabies rashes won’t simply go away on their own in a short amount of time.
Currently, the only treatment for scabies is a topical prescription which must be obtained through a medical provider — no over-the-counter treatments exist.
According to the National Psoriasis Foundation, psoriasis is a non-contagious skin condition that’s characterized by a red, bumpy and/or scaly rash.
Psoriasis rashes are often accompanied by burning, itching and stinging sensations. There are several types of psoriasis, with the most common being plaque psoriasis, which is identifiable by its silvery-white, dry and itchy rashes.
For mild cases of psoriasis, over-the-counter moisturizers, ointments and creams can provide relief.
For more severe cases, or for a particularly bad flare-up, prescription-strength topical and oral medications can be provided by a medical provider.
Ticks are small, bloodsucking parasites that populate every U.S. state in the form of one or more species, according to the CDC. Tick bite rashes can appear as a small red dot or can grow to resemble a large red bullseye.
Since ticks burrow their head into the skin of their host, they will remain attached until they are engorged with blood or forcefully removed. The CDC recommends removing ticks with a pair of fine-tipped tweezers, taking care to apply steady, even pressure without twisting or jerking. Directions are here!
Improper removal can cause the tick’s head or mouthparts to remain embedded in the skin. If those can’t be removed with tweezers, it’s necessary to seek medical attention to avoid an infection.
Red bullseye-shaped rashes like the one in the image above can be an indication that the tick has transmitted Lyme disease, a disease which can cause both short- and long-term symptoms such as fatigue, headache, chills, swollen lymph nodes and other flu-like symptoms.
To treat early-stage Lyme disease, patients are typically prescribed oral antibiotics, while late-stage Lyme disease can be treated with intravenous antibiotics, according to the Canadian Lyme Disease Foundation. No over-the-counter treatments for Lyme disease are currently available.
Although rashes can appear at any time of year, some are more frequently seen during some seasons than others.
Here are the most common rashes for each season, some of which we’ve covered in this article:
- Lyme disease
- Poison ivy, oak and sumac
- Heat rash, a red, blistery rash that’s caused by trapped sweat.
- Polymorphous light eruption, a raised, bumpy rash that’s caused by exposure to sunlight in some people.
- Drug-induced photosensitivity, which occurs when a drug combines with sunlight to produce irritation or an allergic reaction.
- Pityriasis rosea, a patchy, widespread rash that can linger for months.
- Lyme disease
- Poison ivy, oak and sumac
- Heat rash
- Polymorphous light eruption
- Hives, an outbreak of swollen, red and itchy welts that form in response to an allergen or irritant.
- Allergic reactions, such as hives, nasal congestion, sneezing and more.
- Chronic rashes
- Insect bites and stings, such as mosquito bites or bee stings.
- Swimmer’s itch, a rash caused by burrowing parasites that are found in warm bodies of water.
- Drug-induced photosensitivity.
- Allergic reactions
- Eczema and psoriasis
- Pityriasis rosea
When to See a Medical Provider
Though some rashes can be successfully treated at home, it’s important that you recognize the signs of a rash that needs medical attention.
You should see a medical provider if your rash:
- Is covering all or most of your body.
- Came on suddenly and spread rapidly.
- Is accompanied by a fever or flu-like symptoms.
- Begins to blister.
- Is causing pain.
- Appears to be infected.
- Is shaped like a bullseye.
- Isn’t showing signs of improvement after a few days.
- Is unresponsive to over-the-counter treatments.
- Is accompanied by symptoms of a severe allergic reaction, like difficulty breathing or severe swelling.
- Is accompanied with an uncontrollable itch, as this can lead to infection.
An ongoing rash can also be an indication of a chronic skin condition and should be examined by a medical professional.
If you have a rash that needs medical attention, or simply want to treat your rash fast, our providers are here to give you the relief you need.
You don’t have to wait out an uncomfortable rash — a quick visit to your local GoHealth Urgent Care center will scratch that itch right away.
To get rid of your rash and receive the high-quality care you need, find the GoHealth Urgent Care center closest to you using the handy location widget below.
*Disclaimer: This information is not intended to serve as medical advice. Please visit your local GoHealth Urgent Care center to receive a proper medical diagnosis for your rash.
ARKANSASCALIFORNIA – BAY AREACONNECTICUTDELAWARE/MARYLANDMISSOURI – SPRINGFIELDMISSOURI – ST. LOUISNEW YORKNORTH CAROLINAOKLAHOMAOREGON/WASHINGTONGo
Skin Conditions | Cancer.Net
Cancer treatment can affect a person’s skin, hair, and nails. Often, skin problems from cancer treatment are not severe, but they can be uncomfortable and noticeable. Some people may struggle with the visible changes or symptoms caused by a skin condition.
Skin conditions may get better over time, but some may not go away. There are options for managing most skin conditions caused by cancer treatment. Relieving side effects such as skin conditions is an important part of cancer care and treatment. This is called palliative care or supportive care.
Managing skin conditions
Most of the time, prevention is the best way to manage skin problems. Tell your health care team if you have any sores, wounds, rashes, or other problems with your skin. Sometimes an itch, pain, or discomfort is the first sign that a skin condition is beginning. Tell your health care team if you experience these problems, even if they are not visible.
Below is some general information on common skin conditions and how your health care team can manage them.
Rashes. Rashes can be a side effect of chemotherapy, targeted therapy, immunotherapy, radiation therapy, or bone marrow transplants. People may experience a rash that looks like acne or measles. There are several ways to manage a rash based on how severe it is:
For a mild or a moderate rash, your doctor can prescribe drugs called corticosteroids given as a cream. Your doctor may also suggest antibiotic creams or antibiotics that are taken by mouth.
For a more severe rash, your doctor may prescribe corticosteroids to take by mouth and use as a cream. Your doctor may also stop your chemotherapy for a short time and restart at a lower dose.
If these steps do not work, your doctor may refer you to a dermatologist for other treatments.
Dry and itchy skin. Dry skin is called xerosis and itchy skin is called pruritus. This side effect may be more common for people with cancers of the blood, such as leukemia, lymphoma, and multiple myeloma. Dry and itchy skin is also very common with chemotherapy, targeted therapy, radiation therapy, and bone marrow transplants.
To treat dry skin:
Use a moisturizing cream at least twice a day and within 15 minutes of showering.
Avoid products that irritate the skin. This includes soaps, detergents, and creams with fragrance.
Avoid products that scratch or scrub your skin, such as sponges, bath scrubs, or loofahs.
Shower and bathe with warm water. Hot water can dry the skin even more.
When skin is very dry and cracked, use moisturizers containing salicylic acid, urea, ammonium, or lactic acid. These will soften the skin and allow for water to be retained.
To treat itchy skin:
Avoid fragranced skin products.
Use creams with menthol, camphor, or pramoxine, which are available over the counter. You can also use topical steroids prescribed by your doctor.
Try using oral medications called antihistamines. Talk with your health care team about the itching before taking any medication.
Sensitivity to light. Some types of chemotherapy, radiation therapy, and stem cell transplants may make the skin more sensitive to light. This is called photosensitivity. To protect sensitive skin from sunburns when outside:
Cover up with clothing or a hat, especially from 10 AM to 4 PM.
Use a sunscreen that has a sun protection factor (SPF) of at least 15 and is labeled as broad-spectrum. A broad-spectrum sunscreen blocks UVA and UVB rays. Make sure to apply enough to cover your entire body (1 ounce or 35 mL). Reapply every 2 hours or every hour if you are swimming or sweating.
Nail changes. Cancer treatments may cause your nails to lift, break, or develop light or dark streaks or grooves. The cuticle surrounding your nails may also swell and become red and painful. If your nails change from chemotherapy, your doctor may recommend that you cool your hands and feet with ice or wear cold gloves or slippers while you are receiving treatment, especially for the drugs docetaxel (Docefrez, Taxotere) and paclitaxel (Taxol). The cold helps narrow the blood vessels in your hands and feet. This may help reduce the amount of these drugs that reaches the hands and feet.
To help manage any nail changes you experience:
Trim your nails.
Avoid manicures and pedicures.
Wear gloves for tasks such as yard work or cleaning.
Use oils or creams to keep the skin around your nails soft.
Avoid wearing shoes that are too tight.
If an infection is suspected, soak nails for 15 minutes every evening in a solution of white vinegar and tap water in equal amounts.
Radiation therapy-related skin problems. When radiation therapy is used on cancer cells, it also affects healthy skin cells. This can cause the skin to peel, itch, or hurt. Skin damage from radiation therapy often starts after 1 or 2 weeks of treatment. Most often, it gets better a few weeks after treatment ends. If it becomes a problem, your doctor may change your radiation therapy dose or schedule until the condition improves.
Corticosteroid skin creams, such as mometasone (Elocon) cream, may help prevent skin changes from radiation therapy. But make sure you do not apply these creams within 4 hours of radiation therapy. Tell your health care team if you see any open sores or areas where your skin is moist. This may be a sign of an infection that needs treatment with oral antibiotics.
Chemotherapy extravasation or leaks. Chemotherapy extravasation is what happens when chemotherapy given into a vein leaks onto the skin. This can cause pain or burning, and if left untreated, an open wound may develop. If you have pain or burning when you are receiving chemotherapy, tell your health care team right away. They will likely stop the chemotherapy and treat the area around the infusion with topical or injected medications. Your health care team will also show you how to care for the area at home. Then, you will receive chemotherapy through another vein or by another method.
Pressure ulcers or bed sores. Pressure ulcers, or bed sores, are caused by constant pressure on one area of the body. They often form on the heels of the feet, the tailbone, and other parts of the body with a thin layer of fat. To prevent and treat bed sores, try using an air or water pad that lies on top of your mattress. You can also use a low-air-loss bed or air-fluidized bed, which distribute a person’s body weight more evenly over the surface. It is important to seek treatment for bed sores to reduce pain and keep them from getting worse.
Malignant wounds. When cancer breaks the skin, it can cause a malignant wound. Many types of cancer can cause these wounds, but they are most common with skin cancer and breast cancer. Malignant wounds can easily become infected and be very painful or itchy. They may leak a large amount of fluid or blood and have a very strong odor. Placing an odor absorber in the room, such as cat litter or charcoal, can help lessen the smell. Or you can try introducing another odor, such as a burning candle, vanilla, vinegar, or coffee. Keep in mind that fragrances and perfumes can bother some people and may cause nausea. Topical antibiotics such as metronidazole (multiple brand names) may help reduce the odor. Talk with your health care team if you have a malignant wound.
Self-Image and Cancer
Skin Reactions to Targeted Therapy and Immunotherapy
Side Effects of Chemotherapy
Side Effects of Radiation Therapy
Heat rash, sun rash — what’s the difference?
Your skin sure does take the brunt of summer’s hot, humid and sunny weather.
Too much sun can cause a rash. Too much heat can cause a rash. But what’s the difference, how do you treat them and how do you avoid getting them?
Melinda Cooling, vice president of Advanced Practice Providers at OSF HealthCare and chief clinician executive for OSF Saint Gabriel Health, breaks it down for us.
Heat rash, also known as prickly heat, often occurs during hot, humid weather. This rash usually appears in areas where the skin folds or areas where clothes causes friction like armpits, elbow creases, or the groin area.
“This type of rash often is not related to sun exposure but rather when blocked pores trap sweat under the skin,” Melinda said. “A patient may have small blisters or a deep lump that can feel prickly or itchy.”
Other than the hot humid weather, heat rash can develop due to:
- A lot of physical activity
- Illness with fever
- Tight or warm clothing
- Medicine patches that stick to the skin
“Most of the time, heat rash will resolve on its own by cooling the skin with cool compresses and avoiding exposure to the heat,” Melinda said.
Other treatment options may include:
- Using a gentle exfoliator in the bath or shower
- Corticosteroid cream or lotion to help reduce itching and inflammation
- Antibiotic cream or lotion if bacteria is part of the cause
- Drying powders
“If you would have increased pain, swelling, or redness around the affected area or a fever, it could be a sign of an infection and you should seek urgent care,” Melinda said.
Sometimes in the summer, to prevent heat rash may require changing clothes more frequently and keeping the skin cool and dry.
Other ways to prevent heat rash:
- Wear lightweight, loose clothing
- Wear fabric that lets air get to the skin, such as cotton
- Remove bandages or patches
Sun rash starts in areas where the skin is exposed to sunlight.
“It usually presents as a red, itchy rash that groups together and it can feel like it is burning,” Melinda said. “Normally it shows within hours of the sun exposure. If the burn is severe, some patients may feel nauseated or feverish.”
Most sun rashes will resolve on its own within 10-14 days, she said.
“Over-the-counter aloe vera or anti-itch ointments can be helpful. Cool compresses or a cool bath can provide itch relief,” Melinda said. “If you have blisters, keep them clean and dry to help to prevent infection.”
If you have increased pain, fever, swelling or redness, you may have an infection and should seek urgent care, she said.
“The key to sun rash is prevention by using sunscreen with an SPF of at least 30 and to reapply the sunscreen every two hours or more often if you’re swimming or perspiring,” Melinda said. “Protect your skin with clothing and wear a wide-brimmed hat. Avoid the sun between 10 a.m. and 2 p.m. when the sun is most intense.”
Seek urgent care
Whether you’re dealing with a heat rash or a sun rash and aren’t sure what to do, you can seek out urgent care at an OSF Urgo or OSF PromptCare clinic or go online and connect with a board-certified advanced practice provider at OSF OnCall.
Rashes in the elderly | Identification and treatment
Revised: June 2020 Published: February 2013
Our skin is a complex structure of cells and proteins that constantly act to protect and maintain the body’s normal function. With ageing skin, there is a gradual decline in the skin’s ability to adequately sustain these processes. The epidermis thins and the amount of collagen previously abundant within the dermis steadily falls. Characteristic wrinkles develop and the skin becomes increasingly fragile. Langerhans cell numbers within the basal layer of epidermis drop, increasing the propensity towards cutaneous infection. It is therefore unsurprising that the prevalence of different skin disorders varies with age.
Diagnosing a rash
The time-course of a rash can give a useful guide to the likely differential diagnosis. Infectious disease and drug reactions are likely to give a short history whereas psoriasis and eczema are likely to have been present for longer (Box 1).
An additional distinction that provides useful diagnostic information is the presence and quality of itch (Box 2). Premalignant or malignant conditions such as Bowen’s disease will usually be asymptomatic. Psoriasis may often be associated with slight itch, but will rarely cause sleep loss due to scratching. Yet sleep loss due to itch is characteristic of eczema.
Generalised itch (pruritus) is a common complaint among the elderly. The commonest cause of generalised pruritus is xerosis (dry skin), which is easily treated by avoidance of soap products and increased use of emollients. It is critical to distinguish cases of widespread itch with primary skin disease (usually inflammatory) from those with secondary skin disease caused by trauma from chronic scratching (Box 3). Treatment of pruritus relies on the identification of the underlying cause, although this may not always be possible (eg. senile pruritus).
Aqueous cream with 1% menthol is useful in relieving itch in most cases whereas treatments such as phototherapy may be appropriate in specific cases. In generalised pruritus with excoriations, sparing of the central back is typical because the patient is unable reach this area to scratch without the use of an implement (Figure 1). In chronic scratching, characteristic eroded nodules may develop (nodular prurigo), which are commonly seen on the legs and arms. It is typical for there to be a predominance on the non dominant side. Localised itch may also occur as a consequence of chronic scratching, resulting in a focal area of lichenification and hyperkeratosis (lichen simplex).
Important pruritic dermatoses in the elderly
Scabies is an intensely itchy infestation by human-specific mites. Spread is predominantly through skin-to-skin contact, although mites can survive on clothing and linen for several days. Rapid spread within hospitals and other institutions is common, particularly among the elderly and other immunocompromised individuals. Itching is caused by allergic sensitisation to the mites, excrement or eggs which characteristically takes 2–6 weeks following infestation. Subsequent infestations give rise to a quicker onset of the rash and its symptoms. Erythematous papules and excoriations are characteristic. The characteristic scabies mite burrow is a linear grey thread-like lesion, often with a vesicle at one end, and represents the path of the female mite.
Cutaneous lesions are distributed symmetrically and typically affect the inter-digital web spaces, the flexural aspect of the wrists, the axillae and waist. Nodules on the scrotum and penis, or around areolae are almost pathognomonic. The face is typically spared. Elderly patients who may be immunocompromised or immobile are susceptible to infestation by very high numbers of mites, which may cause thick scaly plaques. This form of scabies is commonly known as Norwegian or crusted scabies and is highly infectious. Surprisingly, the associated itch is often less intense. The atypical presentation can often lead to a delay in diagnosis.
Once the diagnosis of scabies has been made the patient and all household contacts should be treated with permethrin 5% lotion or cream on the same day. This should be applied to the whole body including the head and neck in the elderly and the immunosuppressed. Particular care should be taken to ensure application under the nails and between the fingers and toes. Once applied, it should be left on for between 8 to 12 hours before washing off. Bedding, towelling and clothes should be washed above 50oC. The process is subsequently repeated a week later. In cases of allergy or resistance to permethrin, malathion 0.5% aqueous liquid can be used. Following eradication, crotamiton or topical corticosteroids can be used to control the itch, which may persist for several weeks after successful treatment.1
The onset of psoriasis shows a bimodal pattern. Late onset psoriasis (peak at 55 years) may often not show the characteristic well demarcated, scaly erythematous plaques over the extensors, scalp, postauricular sites and umbilicus (Figure 2). Late-onset psoriasis also shows a weaker genetic predisposition. Specific clinical findings such as nail changes and koebnerisation are useful positive findings. Solitary plaques of psoriasis need to be distinguished from Bowen’s disease, superficial basal cell carcinoma and dermatophyte infections.
Seborrhoeic dermatitis is a common condition typically confined to sites of increased sebum production. The pathogenesis of this disorder remains unclear, but an association with increased numbers of malassezia (pityrosporum) yeasts is recognised. Seborrhoeic dermatitis associated with Parkinson’s disease, mood disorders and HIV is often more treatment resistant.2 The scalp is the most frequently affected site and presents with a fine white scale and a diffuse mild erythema.
Facial involvement is often striking by its symmetry, with an ill-defied greasy scale of the forehead, inner eyebrows, nasolabial folds and ears, external auditory canal and post-auricular areas. When present on the chest and intertriginous areas (axillae, groin and inframammary sites), lesions have an orange-brown colour and may resemble flexural psoriasis. More rarely a generalised form of the condition may occur, giving rise to erythroderma. Treatment is directed at reducing the inflammation and tackling the overgrowth of yeast. Low strength topical steroids, such as hydrocortisone 1% cream, in combination with an imidazole to the facial lesions and intertriginous zones is beneficial. Twice weekly use of ketoconazole shampoo to the scalp, as well as to the face and trunk help to maintain remission. Second-line therapies include moderate potency corticosteroids, calcineurin inhibitors (tacrolimus or pimecrolimus) and systemic imidazoles.
Untreated dry skin may progress to asteatotic eczema, which is frequently localised to the lower legs and characterised by a network of shallow cracks in the skin resembling crazy paving (eczema craquelé). In more extensive cases, extension with patchy involvement of the thighs and trunk occurs. The degree of pruritus is variable between patients. Late onset eczema in the elderly is often not associated with atopy. It is important to consider possible underlying causes such as pre-bullous pemphigoid, drug hypersensitivity and paraneoplastic disease in these cases. The avoidance of soaps and irritants, regular emollient therapy and topical corticosteroids are the mainstay of management. Severe cases may need systemic treatment with oral prednisolone or steroid-sparing immunosuppressants.
Mycosis fungoides is the commonest form of Cutaneous T-cell Lymphoma (CTCL), with a median age of onset of 55 years. Typically clonal T-cell populations are restricted to the skin thereby representing a “benign” skin limited lymphoma. The disease is usually mildly itchy and progresses from erythematous, fine scaled patches, typically on non-exposed sites to plaques and tumours of the skin. Lesions vary in size and may be difficult to distinguish from tinea corporis, eczema or psoriasis. A fine wrinkled appearance to the surface of affected skin is an important diagnostic clue (Figure 3). In severe cases clonal T-cell populations can be detected in the blood or bone marrow and the prognosis is worse.3
Drug hypersensitivity induced rashes are the commonest cause of new onset rashes in inpatients. Drugs commonly associated with hypersensitivity reactions include Beta-lactam antibiotics, anti-convulsants, allopurinol and sulphonamides. The typical presentation is of a mildly pruritic maculopapular rash starting one to three weeks after the initiation of a new drug. Initially the rash appears on the upper torso and spreads acrally, often becoming confluent. In a limited number of cases it may progress to complete erythroderma. The presence of fever, tender skin, blistering, mucosal involvement or systemic upset are important markers of severity.
Early discontinuation of the causative drug is essential to prevent progression to a more severe drug reaction such as Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS), Stevens-Johnson syndrome or Toxic Epidermal Necrolysis. Rarely, hypersensitivity rashes may develop several weeks after the discontinuation of a drug. Cross reactivity between drugs of the same group or similar structure can induce drug rashes within days of exposure despite never having encountered the drug before.4
Contact dermatitis may be divided into either irritant contact dermatitis (ICD; skin barrier dysfunction) or allergic contact dermatitis (ACD; type IV T-cell mediated hypersensitivity). Both forms potentially pose a problem in the elderly population but ICD accounts for the majority of cases in this age group as it does in the younger population. ICD most commonly affects the hands due to hand washing. In the hospital setting, irritant dermatitis can be induced by the application of antiseptics (chlorhexidine) and low humidity.
In elderly individuals with reduced mobility, faecal and urinary incontinence may give rise to severe dermatitis of the groin, genitals or buttocks. Unlike ICD, ACD is more itchy. Erythema and scaling are typical, with occasional vesiculation. Elderly patients with chronic leg ulcers are at high risk of sensitisation to topical medicaments or bandages and frequently present with lower limb erythema.
Patch testing should be considered in dermatitis with a well defined border, or if affecting the face, hands or genitals because clinical evaluation is often unreliable. Avoidance of the irritant/ allergen and regular application of greasy emollient (such as 30% yellow soft paraffin/30% emulsifying wax) is often adequate. For severe cases topical corticosteroid ointments can be useful.6
Other important rashes
The development of a paraneoplastic rash maybe the first indication that an individual has an underlying neoplasm.
Tinea corporis and tinea cruris
Dermatophyte (fungal) infections of the skin and nails are common in adults of all ages. Skin lesions are characterised by an itchy, erythematous and scaly lesion (“ring-worm”) except in cases inappropriately treated with topical steroids (tinea incognito). Lesions will typically expand with central clearing and a well defined leading edge, giving rise to an annular or arcuate appearance. Depending on the extent of inflammation, pustules may be also present at the edge of the lesion. The site should be scraped gently with a blade and the scale sent for microscopy and mycological culture. Limited infection can be treated topically with creams such as clotrimazole or terbinafine.
Superficial basal cell carcinoma and Bowen’s disease
Superficial basal cell carcinoma (BCC) and Bowen’s disease (squamous cell carcinoma in-situ; Figure 4) are both localised well defined discoid areas of scaly skin, usually 1–3cm in diameter. Differential diagnosis includes tinea corporis, eczema or psoriasis. Superficial BCCs show a predilection for the trunk whereas Bowen’s disease is usually on sun exposed sites such as the face, forearms and shins. BCCs usually show a raised edge which is best seen on stretching the skin. In trickier cases a biopsy is helpful in establishing the diagnosis. Management with topical chemotherapies such as 5-fluoruracil or topical imiquimod are often successful. Surgery or photodynamic therapy are also used.
Skin disease in the elderly accounts for a significant proportion of presentations to medical practitioners. This article aims to give the reader a firm basis with which to manage dermatoses in this age group. Thorough examination of patients presenting with red scaly rashes is essential in order to successfully diagnose and alleviate the patient’s symptoms, as well as to ensure that those features indicative of serious underlying pathology are not missed.
For more articles on rashes visit our dermatology section
Adam Fityan, Michael R Ardern–Jones, Dermatology, University Hospital Southampton
Conflict of interest: none declared
- NHS Clinical Knowledge Summaries – Scabies Management. http://www.cks.nhs.uk/scabies/ management/detailed_answers/ managing_scabies/choice_of_ insecticide#-262664
- Malassezia, dandruff and seborrhoeic dermatitis: an overview. RJ Hay. British Journal of Dermatology 2011: 165 (suppl. 2): 2-8
- Joint British Association of Dermatologists and U.K. Cutaneous Lymphoma Group guidelines for the management of primary cutaneous T-cell lymphomas. SJ Whittaker. British Journal of Dermatology 2003; 149: 1095–1107
- Skin manifestations of drug allergy. M Ardern-Jones. Br J Clin Pharmacol 2011: 71(5): 672–83
- Acral violaceous erythema and hyperkeratosis. A Fityan. Clin Exp Dermatol 2011; 36(3): 320–21
- Guidelines for the management of contact dermatitis: an update. J. Bourke. British Journal of Dermatology 2009; 160: 946–54
Facial rashes: what’s the diagnosis? | Differential diagnoses
Read this article to learn more about:
- key clinical features that can help diagnose a facial rash in adults
- appropriate management options following a diagnosis
- other factors or complications that should be considered.
After reading this article, ‘ Test and reflect ’ on your updated knowledge with our multiple-choice questions. We estimate that this activity will take you 30 minutes—worth 0.5 CPD credits.
Facial rashes are a common presentation in primary care and are often very distressing for the affected individual, causing embarrassment and frustration. Approximately 14% of GP consultations are for the management of skin conditions1 and around 8% of all antibiotics prescribed in the UK2 are thought to be for the management of skin conditions. Antibiotics have been an important treatment of choice for acne for around 50 years, but with the continuing global increase in the use of antibiotics, and resistance reported in all major regions of the world, the responsible use of antibiotics is of major concern.3
Making a clear diagnosis before starting treatment can help improve outcomes and management. The Primary Care Dermatology Society (PCDS) has developed a range of guidelines on skin conditions, which aim to help GPs create targeted, rational treatment plans for people with skin conditions.
The following differential diagnosis case studies will explore possible causes of facial rashes, with the aim of making it easier to understand the presentations and complexity.
Samantha is 45 years old and works in a media job, which involves entertaining guests and public speaking. Samantha tells you that 18 months ago she noticed she had started blushing more, especially when consuming alcohol and when she is stressed due to public speaking. Her skin often feels flushed and hot. She has recently started to get some raised pimples on the skin. She mentions that on a recent trip to Spain, her skin seemed to flare in the sunlight.
The likely diagnosis is rosacea. The following clinical features are often observed in people with rosacea (see Figure 1, above):
- telangiectasia (small vessel growth)
- skin inflammation across surface
- absence of open comedones (blackheads).
Making a clear diagnosis is important with rosacea so that the patient can develop a better understanding of the condition, which in turn leads to better management.
Rosacea is a chronic skin condition requiring long-term therapy to maintain control of symptoms. A stepwise approach targeting the predominant symptoms of the patient’s rosacea is essential; the PCDS rosacea guideline can advise on appropriate treatment options.4 There are also general measures that patients can take to help themselves, such as avoiding direct sunlight and using face lotions with sun protection factor (30+).5 Topical brimonidine can be used to treat erythema symptoms in adults.4 For more information on the different types of rosacea and appropriate oral/topical treatments, read the Guidelines in Practice top tips article on rosacea.
Ocular rosacea occurs in over 50% of people with rosacea. Symptoms include:4,6
- gritty eyes with blepharitis
- inflammation of the lids and meibomian glands
- conjunctival telangiectasia.
There may also be stinging or burning of the eyes, dryness, irritation with light, or foreign body sensation.6 Refer to the PCDS rosacea guideline for information on managing ocular symptoms.4
For Samantha, the facial flushing was a predominant feature. Her symptoms improved after using brimonidine gel for 4 weeks. Following her GP’s advice, she now takes care to limit her exposure to sunlight, and uses high-factor sunblock. Samantha has been using tips from the National Rosacea Society on self-management and feels empowered to control her symptoms, even though no ‘cure’ has been achieved.
- for patients:
- for practitioners:
John is 21 years old and has come to you with symptoms of depression. A closer discussion reveals that much of his unhappiness stems from his ‘spots’, which developed a few years ago. He has tried various over-the-counter products without much luck and is now reluctant to leave home and is socially isolated.
The likely diagnosis for John is acne. The following clinical features are often present (see Figure 2, above):
- open and closed comedones (black and white heads)
- inflammation surrounding the comedones
- seborrhoea (increased sebum production)—the patient may describe this as a ‘shine’ to their skin.
Occasionally, the inflammation and infection can lead to scarring. In most cases, this can be prevented with the timely administration of a suitable treatment.7
The most important aspect of acne treatment is support and monitoring for improvement, with close attention to development of scarring. It is not appropriate to send a patient away with no plans for further review. Inform the patient that it may take 4–8 weeks of treatment before there are any signs of improvement8 and support them with compliance. Selecting an appropriate treatment for acne depends on the clinical findings and patient choice; follow the stepwise approach described in the PCDS acne vulgaris guideline to inform this.9 For more information on management, see the Guidelines in Practice top tips article on acne, which includes a helpful treatment pathway. Oral antibiotics should not be prescribed as monotherapy for the treatment of acne.8
Acne can cause a significant degree of psychological distress to the affected individual. In the author’s clinical experience, people with acne often feel that they are not taken seriously by healthcare professionals. There are links between acne and depression as well as a risk of self-harm. 9 It is worth asking the patient about their mental health state, which may indicate referral to secondary care if the acne is causing significant distress.8 Acne scarring is also an important aspect to identify as this is a marker for severity but also requires urgent action to prevent further scars forming.
John needs to be monitored carefully and regularly. He will likely need a combination of topical treatment and oral antibiotics—especially in view of the psychological impact the acne is having on him. If there is an improvement and his mood stabilises then it would be reasonable to persist with treatment for up to 3 months. If his mood deteriorates or his skin worsens then referral to secondary care would be warranted. This psychological distress needs to be clearly stated in the referral letter, as some commissioners will not accept referral unless multiple courses of antibiotic therapies have been tried.
- for patients:
- for practitioners:
Anthony is a 34-year-old man. He presents with a salmon-pink rash on his face, which he says appeared a few months ago in the middle of winter. On examination, the rash is found mainly to affect the creases of his face but also appears slightly on the scalp. Anthony says that he is not particularly bothered about it, but he has found the scales and dryness uncomfortable. He explains that the rash first appeared last winter, but it got better over the following summer when he was in the sun.
The likely diagnosis is seborrhoeic dermatitis. The following clinical features are often present (see Figure 3, above):
- ill-defined plaques in skin folds on both sides of the face
- itchy and flaky skin
- salmon-pink rash.
The NICE Clinical Knowledge Summary on Seborrhoeic dermatitis recommends treatment for at least 4 weeks with ketoconazole 2% cream, applied either once or twice a day.10 Other imidazole creams, such as clotrimazole, econazole, or miconazole, can be used as alternatives.10 A mild corticosteroid might also help with inflammation.10 Once the symptoms settle, advise the patient to reduce the frequency of application to once or twice a week to prevent recurrence.10
Seborrhoeic dermatitis is the most common skin manifestation of HIV infection. There is a current drive to destigmatise HIV testing in primary care and increase uptake. This does not mean everyone with seborrhoeic dermatitis needs an HIV test, but it should raise a red flag if a patient with severe or widespread seborrhoeic dermatitis repeatedly presents to general practice and has risk factors for HIV. For more information and help with increasing HIV testing in your practice, visit the Faculty of Sexual and Reproductive Healthcare’s web tool on HIV.
Anthony was prescribed ketoconazole cream for 4 weeks—his skin showed a good response to the treatment. Following his GP’s instructions, Anthony then went on to use the cream once a week in the winter months to reduce the likelihood of reoccurrence.
- for patients:
- for practitioners:
Kelly is a 21-year-old shop assistant and has two children. Kelly is usually fit and healthy, and does not come to see the GP very often, but when you call her from the waiting room she looks unwell and has a red butterfly rash over her cheeks. She says she feels like she has flu. On examination, you notice a malar rash across her cheeks.
The diagnosis is cutaneous lupus erythematosus. Look out for a malar rash across both cheeks (see Figure 4, left). Photosensitivity is common, and the lesions are often induced by exposure to sunlight.11
Cutaneous lupus erythematosus is very rare and practitioners may never see a case in primary care. The author has included it in this differential diagnoses article as often there is fear of missing a critical diagnosis. Generally, rheumatology or dermatology specialists would investigate and manage this disease. If you suspect that a patient has either cutaneous or systemic lupus, contacting the local on-call dermatology service for advice would be the best option as different areas manage the disease in different ways. Treatment depends on the severity of the disease and how it affects the individual. Cutaneous lupus erythematosus is an autoimmune disorder, and may respond to treatment with low-potency immunosuppression medications such as hydroxychloroquine.12
Cutaneous lupus erythematosus has some features similar to rosacea and should be considered if the patient has not responded to rosacea treatment, or if systemic symptoms are present.
- for patients:
- for practitioners:
- Okon L, Werth V. Cutaneous lupus erythematosus: diagnosis and treatment. Best Pract Res Clin Rheumatol 2013; 27 (3): 391–404.11
Managing facial rashes can be frustrating for both patients and clinicians. The key to success is to make a clear diagnosis and to aid the patient with treatment compliance. Offering a review appointment and discussing how to manage flares are essential elements for developing a patient-led management plan.
After reading this article, ‘ Test and reflect ’ on your updated knowledge with our multiple-choice questions. We estimate that this activity will take you 30 minutes—worth 0.5 CPD credits.
- Kerr O, Benton E, Walker J et al. Main plenary sessions: summaries of papers—dermatological workload: primary versus secondary care. Br J Dermatol 2007; 157 (suppl. 1): 1–2.
- Clark C. Antibiotic use for acne reducing effectiveness elsewhere, says leading dermatologist. Pharm J 2014; 293: 7820–821.
- Walsh T, Efthimiou J, Dreno B. Systematic review of antibiotic resistance in acne: an increasing topical and oral threat. Lancet Infect Dis 2016; 16 (3): e23–33.
- Primary Care Dermatology Society. Rosacea. PCDS, 2016. www.pcds.org.uk/clinical-guidance/rosacea (accessed 17 May 2017).
- Primary Care Dermatology Society. Rosacea—primary care treatment pathway. PCDS, 2016. Available at: www.pcds.org.uk/ee/images/uploads/general/Rosacea_Pathway-aw_cx.pdf
- Medscape. Ocular rosacea. WebMD LLC, 2017. emedicine.medscape.com/article/1197341-overview
- Primary Care Dermatology Society. Acne vulgaris. PCDS, 2017. www.pcds.org.uk/clinical-guidance/acne-vulgaris (accessed 17 May 2017).
- Primary Care Dermatology Society. Acne—primary care treatment pathway. PCDS, 2015. Available at: www.pcds.org.uk/ee/images/uploads/general/Acne_Treatment_2015-web.pdf
- Lynn D, Umari T, Dunnick C, Dellavalle R. The epidemiology of acne vulgaris in late adolescence. Adolesc Health Med Ther 2016; 7: 13–25.
- NICE. Scenario: seborrhoeic dermatitis—face and body. NICE Clinical Knowledge Summary. NICE, 2013. cks.nice.org.uk/seborrhoeic-dermatitis#!scenario:2 (accessed 17 May 2017).
- Okon L, Werth V. Cutaneous lupus erythmatosus: diagnosis and treatment. Best Pract Res Clin Rheumatol 2013; 27 (3): 391–404.
- Kuhn A, Aberer E, Bata-Csörgő Z et al. S2k Guideline for treatment of cutaneous lupus erythematosus—guided by the European Dermatology Forum (EDF) in cooperation with the European Academy of Dermatology and Venereology (EADV). J Eur Acad Dermatol Venereol 2016; 31 (3): 389–404. G
90,000 drug and physiotherapy – clinic “Dobrobut”
Possible causes of itching of the skin of the body: which doctor to contact
Skin itching is an unpleasant sensation accompanied by the need for mechanical irritation of the skin, that is, it causes a constant desire to scratch the disturbing place. The types of itching of the skin depend on the reasons that provoked it. Itching is a symptom of various diseases, disorders and conditions. It can result from infection, inflammation, allergies, insect bites, and occur during the normal wound healing process.Itching significantly affects the general condition and quality of life of patients. It causes insomnia and, in severe cases, leads to depression.
Causes of itching
Itching is often caused by a skin condition, but can sometimes be a sign of a serious medical condition. In some cases, it is not possible to identify a specific cause of itchy skin.
Skin diseases causing itching:
- Eczema. Severe itchy skin rash in adults, accompanied by dryness, redness, flaking.Children’s eczema is distinguished separately. Red rashes on the skin of a child with a pronounced exudative component may indicate eczema.
- Contact dermatitis. Skin reaction resulting from contact with an irritant or allergen.
- Urticaria. Dermatitis of an allergic nature, with a red, itchy rash.
- Lichen planus. Itchy rash of unknown etiology.
- Psoriasis. First, pink spots appear on the skin (papules), then they merge, forming plaques.
- Prurigo (prurigo). Small blisters on the skin that itch a lot.
- Dandruff. A condition causing dry white or gray flakes of dead skin to appear on the scalp. Dandruff can cause an itchy scalp.
Itching can be caused by an allergen or irritant: cosmetics, metal in jewelry, latex. Allergy to certain foods, medicines is also accompanied by itching. Skin allergy ointment relieves itching and relieves the condition.
The skin of the hands is very dry, scaly and itchy
Other possible causes of itchy skin on the body:
- Scabies. The disease is caused by a female scabies mite. An infected person is worried about intense itching of the skin, which is worse after a hot shower, in the evening and at night.
- Head and pubic lice.
- Insect bites: bees, wasps, mosquitoes, fleas, bedbugs.
The skin of the hands is very dry, flakes and itches – a condition typical of a fungal infection, and can also signal metabolic disorders or be the result of contact with aggressive media.A dermatologist should make an accurate diagnosis and prescribe treatment.
Why does the skin on the legs itch and redness appear? Symptoms can indicate both a skin or allergic disease, and an endocrine or autoimmune pathology.
Itching can be a symptom of infection:
- Chickenpox or other viral infection.
- A fungal infection (athlete’s foot) that causes itching between the toes.
- Vaginal candidiasis, which causes itching of the genitals and surrounding skin (inner thigh).
Diseases of a general nature that may be accompanied by itching of the skin
Endogenous causes of itching:
- Hemorrhoids – expansion of the veins of the rectum with the formation of external and internal nodes.
- Thyroid pathology. Read more about thyrotoxicosis on our website https: // www.dobrobut.com.
- Iron deficiency anemia – a decrease in the content of hemoglobin in erythrocytes.
- Polycythemia – an increase in the concentration of red blood cells in the blood.
- Uremia – self-poisoning of the body in severe kidney pathologies.
- Liver diseases, eg primary biliary cirrhosis, hepatitis.
- Renal failure – impaired renal function.
- Metabolic disorders (diabetes mellitus).
- Certain types of cancer: liver, pancreas, leukemia, Hodgkin’s lymphoma.
Sometimes itching is associated with a psychological condition (depression, anxiety). In women, itching can be caused by hormonal changes during pregnancy or after menopause. Senile itching of the skin in older people occurs in about 50% of people over 70 years of age in the form of nocturnal attacks. The main causes of senile itching are endocrine disorders, atherosclerosis, dry skin. Senile pruritus is a diagnosis of exclusion, meaning that other causes of itching must be ruled out before it is diagnosed.
Treatment of pruritus and irritation
The most effective treatment for pruritus is the diagnosis and treatment of the underlying disease, disorder or condition causing itching. General therapy includes the use of sedatives and antihistamines, hyposensitizing agents (calcium preparations, sodium thiosulfate), mast cell membrane stabilizers (ketotifen), enterosorbents.
Treatment of skin itching and irritation is carried out using physiotherapeutic and balneological methods.External therapy is widely used, although the effect of most local drugs is very short-lived. Usually, powders, ointments, alcohol and water solutions, pastes, “talkers” are prescribed. Antipruritic action is possessed by: glucocorticosteroids, solutions of anesthesin, diphenhydramine, water with table or apple cider vinegar, infusion of chamomile flowers.
How to relieve facial skin irritation? It is necessary to moisturize the skin of the face, use hypoallergenic pharmaceutical cosmetics, thermal water. In case of itching of any genesis, provocative factors should be eliminated: do not contact with irritants, avoid dryness and degreasing of the skin.
Consultation with a dermatologist
Itchy skin at Angio Line Medical Center. Make an appointment
Itching is a clear symptom of skin diseases. An itchy sensation on the skin indicates the body’s response to inflammation.
With alopecia (focal alopecia) itching is a common symptom along with burning and soreness in the affected area.
DERMATOLOGICAL DISEASES ASSOCIATED WITH ITCHING
Chronic disease leading to relapses. In an adult, it develops on the bends of the limbs. Rashes with blood pressure are represented by papules, scaling and cracks.
Severe itching is the main symptom of AD.
Inflammation of the subcutaneous vessels. In the eczematoid type, it manifests itself in swelling, redness, crusts and itching.
Skin inflammation arising as a reaction to mechanical action of allergens (cosmetics and detergents, lubricating oils, medicines).
Symptoms: itching, burning and soreness on mechanical contact.
Skin inflammation occurs on the chin and at the mouth. The disease develops quickly, the resulting rash causes intense itching.
Lesion of skin areas with developed sebaceous glands, caused by fungi.Stress, metabolic disorders and immune diseases lead to this type of dermatitis. A reddish rash leads to severe itching.
With papular eruptions, Quincke’s edema and patchy toxidermia, severe itching is characteristic.
A disease of complex origin, causing cracks, crusts on the skin, less often papules and vesicles. It is characterized by severe itching and burning.
Prurigo (or Prurigo)
Allergic reactions of the body to diseases of the gastrointestinal tract, drugs, metabolic disorders and other problematic phenomena can cause chronic inflammation of the skin.
Itchy nodular or papular lesions cover the skin at the folds of the limbs. The excruciating itching appears in attacks after the intensification of the rash, interfering with an active life.
The scabies mite settles in the skin and causes allergic reactions. The increased sensitivity of the body due to the presence of the parasite leads to itching.
Itching worse in the evening and at night when tick activity increases.
A genetic disorder in which the body’s inadequate production of antibodies leads to blisters on the skin.Pemphigus is characterized by severe itching.
The skin is covered with well-defined, scaly, scaly eruptions. The disease is accompanied by burning, dryness and always itching of varying intensity, depending on the psoriatic type and degree of the disease.
A parasitic disease in which blood-sucking lice cause inflammation of the skin. Insect saliva released from bites leads to itching due to an allergic reaction of the body.
Pediculosis carriers live in the scalp, folds of clothing, pubis and armpits.
With a simple form of the disease, bubbles with a cloudy liquid appear on the lips or in the genital areas. They itch and burn.
In the spontaneous form, the appearance of edematous blisters is accompanied by itching.
Numerous grouped eruptions on the elbows, knees, genitals, on the mucous membrane of the mouth, causing itching.
Itchy eruptions localized on the limbs, abdomen and thighs. Over time, the rash turns into dense blisters, leading to skin erosion.
Lymphatic tumor of the skin, accompanied by severe itching due to the appearance of nodes, spots and plaques with fungal mycosis.
Plaque formation causes severe itching.
Mycoses of feet
With rubrophytosis of the feet, moderate itching occurs at the sites of the rash.
An allergic reaction of the skin to sunlight causes itchy patches, vesicles or plaques. The likely cause of photodermatosis is a disorder in the immune system, which cannot adequately respond to solar radiation.
Dystrophic epidermolysis bullosa pruriginous
Congenital or childhood inflammatory disease resulting in blistering with slight mechanical contact with the skin. It is accompanied by severe itching.
Benign skin tumor manifested in the formation of itchy rounded papules.
Itchy skin severely reduces quality of life, disrupting sleep and distracting from daily activities. If it appears, consult a dermatologist.
90,000 Which doctor should I contact when a skin rash appears
Dermatologists of Moscow – latest reviews
An excellent doctor.The reception went well. Oksana Sergeevna explained everything, prescribed the necessary treatment that helps me. Polite, attentive doctor. After completing the course, I will contact this specialist again.
October 14, 2021
I really liked the specialist.I have been treating my disease for a long time, but this is the first of several dermatologists who explained everything clearly and his method is significantly different from others. I have also received a treatment regimen and am planning a follow-up appointment. Anna Andreevna did not prescribe unnecessary tests, but only everything in the case. She is polite, correct, attentive, interested. This doctor was recommended to me by a colleague who has already cured such a disease with her.
October 14, 2021
The reception went well.Vladimir Georgievich prescribed medication and referred him for consultation to another specialist. The doctor is friendly, attentive, generally satisfied with the reception.
October 11, 2021
The doctor is a professional, tactful, attentive.Things are good. I liked everything. At the reception, Zhamilya Akhmetovna conducted an oral survey, a device examination, and wrote out appointments. I cannot assess the result yet, not much time has passed. She explained everything clearly, answered all my questions.
October 13, 2021
The reception went well and did not have to wait long.The doctor talked about the nuances of my problem, ordered me to pass the necessary tests. Oleg Anatolyevich is attentive, takes work seriously, it is clear that he is a professional in his field.
October 14, 2021
The doctor seems to be adequate, but prescribes a large number of tests that are not really needed.I went to the doctor with two problems, a specialist examined me, carried out all the necessary measures. The specialist helped me choose the shampoo.
October 14, 2021
At first the doctor listened carefully.After she insisted on being tested in this particular clinic (on Belyaevo), she supposedly trusts only their specialists.
After the first analysis came, the doctor began to say that I had cystitis, although I know what it is, and my kidneys were clearly hurting, which I have repeatedly said.
I will never return to this doctor.
As a result, I went to another specialist, where they put me on pyelonephritis.
12 October 2021
Marina Yurievna conducted an initial examination, sent for tests for examination.Also, the doctor prescribed the necessary treatment and gave some advice. The effect of the drugs is already there. I would like to see this doctor again! I was satisfied with the quality.
October 11, 2021
The doctor explained everything clearly and popularly, prescribed the necessary treatment.Getting started!
October 14, 2021
Elena Vladimirovna is a very attentive doctor.She answered all my questions, sent me for a blood test, made appointments, made recommendations. All her appointments have already helped me. I was very pleased. The reception lasted about 30 minutes, this time was enough for me.
October 14, 2021
Show 10 reviews out of 24,496 90,000 From a clean face.Skin rashes can indicate serious illnesses | HEALTH: Medicine | HEALTH
Got nervous? Spots may appear on the body. Stomach problems? Sprinkled face. Perhaps many have experienced this for themselves. No wonder the skin is called the mirror of the body.
What signals does our body send, what does the rash tell about and how they can turn out, told a dermatovenerologist of the highest category of the Tver regional center named after Avayev Andrey Garmonov .
Signal from within
Ekaterina Evseeva, “AiF-Tver”: Andrei Alexandrovich, they say, you can identify much more serious diseases by skin rashes.This is true?
Dermatovenerologist of the highest category of the Tver Regional Center named after Avaev Andrey Garmonov. Photo: From personal archive / Andrey Garmonov
Andrey Garmonov: Skin is a kind of litmus test that reacts to a malfunction of internal organs. Many rashes on the face, body, limbs are a wake-up call from the body, its attempt to warn about the changes taking place inside. Let’s look from top to bottom. If rashes appear on the scalp, this indicates metabolic disorders.The sebaceous glands are located here. With hormonal imbalance, sebum production increases. A favorable environment for microorganisms is formed, and inflammation of the follicles occurs. Most often this leads to the appearance of seborrhea. It can be in the form of dandruff, itching, flaky patches on the scalp, etc. Many people buy special shampoos, wash their hair every day, but the hair still quickly becomes dirty, and the itching does not go away.
It is necessary not only to remove the symptoms, but to look for the cause of the disease. Hair loss can indicate problems with the cervical spine.Thinning hair, poor growth, brittleness – it all depends on the blood circulation in the head. If something pinched in the neck, it means that the blood began to flow worse to certain organs. With a decrease in immunity and hormonal changes, the activity of demodex (subcutaneous tick) increases. This often manifests itself in the form of red spots and acne on the face. Demodex often appears even on the eyelashes, as a complication of blepharitis, conjunctivitis. People are treated by an ophthalmologist, but in fact they need to see a dermatologist.A rash near the mouth indicates problems with the gastrointestinal tract. Due to problems with the lumbar spine, spots and peeling on the legs can occur, as well as fungal diseases of the feet and nails. Improper diet, inappropriate household chemicals or cosmetics can also cause skin rashes.
At the same time, not all spots are treated by a dermatologist. Sometimes for help you need to go to a gynecologist-endocrinologist, andrologist-urologist, gastroenterologist, etc.
Rash from stress
– Many people try to fix problems on the skin themselves.Today there are so many ointments – it would seem that there is no need to go to the doctor!
– Don’t feed our man with bread – let yourself diagnose yourself. Many people like to be treated with herbs, but most of them are strong allergens. You cannot engage in self-medication. Rashes are often similar, but what works for one rash may be contraindicated for another. Amateur performance can lead to serious consequences. Moreover, some skin diseases are not treated at all, you have to live with them.These are psoriasis, eczema, atopic dermatitis, severe forms of acne. It happens that many are delaying treatment, hoping that it will pass by itself. If the body gives a signal, listen!
– What skin diseases are common among residents of the Tver region?
– In recent years, the number of viral infections has increased: herpes, papillomas and others. Often people are treated with atopic dermatitis and urticaria. There are many patients with psoriasis, and this does not depend on age and gender.Psoriasis is incurable, but remission can be achieved for years to come. During the period of exacerbation due to severe rashes, resembling scabs, such patients often have to deal with disgust from others. However, you cannot get infected with psoriasis. The disease is transmitted genetically (and even after two or three generations) or acquired during life. It can be provoked, for example, by severe stress. A person has survived the death of loved ones, a car accident, he has serious problems at work – all this can affect the skin.In general, many skin diseases are caused by nervous disorders.
What a disgusting “mug”!
– Another painful “sore” – erysipelas, popularly called “erysipelas”. Why do they arise?
– Erysipelas looks like severe redness of the skin. It usually appears on the legs and arms, less often on the face and trunk. “Erysipelas” always begins the same: high fever, chills, headaches and muscle pains. It is often confused with the flu.Most often, skin trauma – abrasions, scratches, cracks, bruises – leads to erysipelas of the hands and feet. If you do not start treatment on time, serious complications can occur, up to damage to the lymph nodes and blood vessels. Erysipelas is treated from ten days to three months. It depends on which part of the body is damaged, on the person’s age and chronic diseases. Diabetes mellitus is very fond of skin diseases. If the patient suffers from this ailment, treatment becomes more difficult. Antibiotics, ointments, lotions, creams help from “face”.To prevent a relapse, you need to undergo a preventive examination by a dermatologist every six months, and also not to start a chronic disease that you have.
Diabetes mellitus is very fond of skin diseases. If the patient suffers from this ailment, treatment is complicated
According to the quota – even to Moscow
– In Tver with skin problems, you can turn to the Avayev Center for help. But what about residents of areas where there are no dermatologists?
– In recent years, the region has partially resolved the issue of the lack of specialists.Now 35 dermatovenerologists work in the region. They are distributed so that there is a doctor for every 100 km. It turns out that almost every district has its own specialist. There are dermatologists in Toropets, Nelidov, Rzhev, Konakov, Vyshny Volochyok and other cities of the Tver region. The specialists of our center often travel to the districts themselves. Sometimes doctors from the provinces call and say that the patient needs a consultation in Tver, but he has no money. In this case, they send me a photo of the patient. We study the condition of the skin from photographs, collectively prescribe treatment.We try to find a way out of any situation.
– Is the help at your center free?
– Of course! We accept compulsory health insurance policies free of charge. We also cooperate with skin centers in Moscow and St.
P.N. Kashkina and others. According to quotas, residents of our region can also undergo treatment in federal clinics, we give referrals in cases of severe torpid course of the disease.Each resident of the Tver region, if necessary, can easily sign up for a free consultation with federal specialists. This can be done through the website of this or that center.
General advice on skin care
- Do not go out in the sun or in windy weather without protective equipment.
- Prefer a shower over a bath, after which the skin becomes drier. When washing, use warm water.
- To maintain the beauty of your skin, drink more water: approximately eight glasses a day.
- Eat fruits and vegetables daily that are rich in antioxidants. This will help maintain the beauty and health of your skin.
- Get enough sleep to keep your skin glowing with health. The body needs 7-9 hours of sleep.
- Stop smoking. Due to this bad habit, the complexion becomes dull, and the skin ages faster.
90,000 Tanning allergy. What diseases can provoke the sun’s rays
Why do some people get a beautiful tan in the sun, while others have itchy blisters and a red rash? Ultraviolet radiation can cause various allergic reactions, they must be distinguished in order to properly treat the disease.
How do solar urticaria and photodermatosis occur and how to treat them? This was told by the doctor of medical sciences, professor of the Department of Skin and Venereal Diseases named after V.I. V. A. Rakhmanov, Sechenov University, PhD (Great Britain) Elena Borzova.
From blisters to shock
Elena Borzova: Solar urticaria occurs quite quickly, often less than 5 minutes after exposure to sunlight. Much less often – within 20 minutes.For example, people with increased sensitivity to solar radiation (photosensitivity) may develop solar urticaria literally a few minutes later in the open sun. Itchy blisters appear on the skin. However, solar urticaria is also resolved quickly, after 15-30 minutes, up to a maximum of 1 hour. But, once it appears, solar urticaria may recur. Patients with solar urticaria should go out into the sun, such as going on a picnic, and they will react immediately. Predominantly solar urticaria occurs on exposed areas of the body.And since solar urticaria is possible as a reaction to different ranges of ultraviolet radiation, sometimes thin clothing does not help to prevent itchy blisters in summer. The penetration of ultraviolet rays through the window glass in the room or through the car windows is possible.
Sometimes there are more severe symptoms: headache, heart palpitations, a general deterioration in well-being up to fainting, and in the most severe cases, anaphylactic shock is possible.Therefore, such patients should be promptly examined and diagnosed by specialists.
Solar urticaria can be chronic and long-term. In some, rashes predominate in the spring-summer period, in others they can be observed throughout the year. But they are always due to ultraviolet radiation. In some patients, the disease can go away on its own, that is, there is a spontaneous remission.
– How to distinguish solar urticaria from sunburn or other sun allergies?
– There are various photodermatoses – diseases with skin lesions that occur under the influence of ultraviolet radiation.For example, photoallergic contact dermatitis is an inflammatory process of the skin that occurs in areas of combined exposure to a drug or cosmetic product and ultraviolet radiation in persons with hypersensitivity to these drugs. In contrast to solar urticaria, photoallergic contact dermatitis usually appears more delayed, several hours after intense exposure to ultraviolet radiation. And it takes much longer.For detailed differential diagnosis, specialist advice and additional examination, including phototesting, are required.
– Who has the most frequent reactions to solar radiation?
– Most often they get sick between the ages of 20 and 40. The risk is higher if relatives have similar reactions to sunlight, in the case of taking certain medications. In general, this is an understudied area.
– What happens to the body with solar urticaria? Why is there such a reaction to the sun?
– It is assumed that under the influence of solar radiation, the structure of some proteins in the skin changes and they become photoallergens.Altered proteins can cause the production of class E immunoglobulins, which are found on the surface of the skin’s mast cells. As a result of this activation of mast cells, the release of histamine and other mediators begins in them, which cause the formation of an itchy blister on the skin.
When are oranges dangerous?
– I heard that some cosmetic and perfumery products, medicines can also provoke reactions to solar radiation.
– Cosmetics and medications can cause photoallergic contact dermatitis. The most common allergic reaction occurs to sunscreens and nonsteroidal anti-inflammatory drugs. It can be triggered by a number of drugs in cardiology, for the treatment of diabetes mellitus, some diuretics, antibiotics, especially doxycycline, tetracycline, fluoroquinolones, sulfonamides, some oral contraceptives and even some antihistamines.In addition, perfumery products based on musk, essential oils, such as bergamot, orange. Therefore, it is recommended not to use perfumery if you plan to sunbathe or visit the beach.
– How so? Sunscreens are designed to protect you from the sun, but can cause problems during tanning.
– Some of them really can. After all, such funds are a composition of very many ingredients, to some of which there is a reaction in persons with hypersensitivity to these components.Therefore, in case of a reaction to photoprotective agents, it is important to consult a specialist, exclude contact dermatitis and choose a safe drug.
By the way, some vegetables and fruits, plants can also cause photoallergic reactions. This angelica, hogweed, from products – celery, parsley, fennel, figs, some citrus fruits. Moreover, in persons with high sensitivity, even touching the face can cause a reaction if trace amounts remain on the fingertips after contact, say, with celery or parsley.
Some diseases, such as lupus erythematosus, porphyria and pellagra, may be associated with photosensitivity.
– Is solar urticaria possible in our mid-latitudes or is it manifested only in southern resorts?
– Solar urticaria refers to rare variants of urticaria, provoked by ultraviolet radiation of various ranges: ultraviolet rays of the A and B spectrum, as well as the visible spectrum.Of course, it is possible in middle latitudes as well. In Scotland, a study was carried out, which showed that even in northern latitudes, the disease, although rare, is found.
Selfie for a doctor
– How are solar urticaria and photodermatosis treated?
– If symptoms occur, you should contact a specialist as soon as possible for differential diagnosis. Phototesting is mandatory to confirm solar urticaria and other photodermatosis.With the help of phototesting, the range of solar radiation that causes a given disease is determined. For photoallergic contact dermatitis, photoapplication tests are used with drugs that are suspected of developing this reaction.
Many patients come to an allergist-immunologist or dermatologist when they return from vacation, a few weeks after the occurrence of an allergic reaction. In such a situation, it is quite difficult to interpret the symptoms.Therefore, it is advisable to photograph changes on the skin if they occur while relaxing on the beach and consult a specialist in a timely manner.
Treatment also has fundamental differences. For urticaria, non-sedative antihistamines are used; for chronic urticaria, more specialized approaches are possible. Phototherapy is successfully carried out in our clinic, it is an effective method and is the effect of increasing doses of ultraviolet radiation to develop tolerance.With solar urticaria, severe options are possible, up to systemic reactions of the body, which may require urgent help. In the case of photoallergic contact dermatitis, it is necessary to exclude the culprit photoallergen; it uses topical glucocorticosteroids and other drugs.
Safety rules in the sun
- Try not to sunbathe during the most active sunlight, from 10-11 to 16 hours.
- Before going to the beach, it is advisable not to use deodorants, creams, perfumes.
- Be sure to use high SPF sunscreens.
- Before sunbathing, exclude foods that may cause photoallergic reactions.
- Wear clothing that protects against intense sunlight whenever possible. If a person has confirmed solar urticaria, then they are advised to avoid exposure to sunlight and wear clothing and hats that protect from sunlight.
- If skin manifestations occur, consult a specialist.
90,000 Where does a body rash come from and what to do about it
Body rashes are common. Most often, it does not harm health: small red spots, pimples, bubbles spoil the appearance, itch, but disappear quite quickly by themselves.
However, sometimes rashes can be symptoms of serious and even life-threatening disorders.
When you need to see a doctor urgently
Go to the doctor, dermatologist, nearest emergency room as soon as possible, or call an ambulance if :
- The rash has spread all over the body.
- The rash is accompanied by a fever. A temperature above 38.3 ° C indicates an acute inflammatory process.
- The rash on the body appeared suddenly and is getting thicker.This may be a sign of a powerful allergic reaction that runs the risk of developing into Quincke’s edema or even anaphylactic shock. Take special care if a rash develops in the face and neck area. If you notice that it becomes difficult to breathe, dial 103 or 112 immediately.
- The rash is blistering. That is, in place of numerous red spots, bubbles filled with liquid begin to appear.
- It hurts to touch the rashes.
- The rash on the body is very itchy, and you easily comb it until it bleeds.In this case, there is a risk of introducing infection into the wounds and getting blood poisoning.
If there are no threatening symptoms, exhale. Most likely, nothing terrible happens to you.
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What are the causes of the rash on the body
It is often difficult to determine on the fly where the rash came from. Here are some of the more common options.
Photo: Maxop ‑ Plus / Shutterstock
A mosquito or, say, a bee bite is easy to identify: in its place there is a round, dense swelling that itches or hurts.Such damage to the skin cannot be confused with a rash. But there are insects whose bites are like rashes. These are, for example, fleas – bed or sand fleas.
If you find itchy red spots on your skin in the morning or after the beach, you may have been bitten.
Photo: wolfness72 / Shutterstock
She is also an allergic reaction of to ultraviolet light (“sun poisoning”). The rash can be different:
- small itchy redness;
- flesh-colored pimples that feel like sandpaper; 90 016 90 015 blisters;
- spots of distinct red color, tending to merge into a single whole.
Most often, sun allergy occurs due to the fact that during sunburn some harmful substance was present on the skin – cream, lotion, medicine, plant juice – and ultraviolet light turned it into an allergen. Alternatively, you are taking medication that makes your skin sensitive to the sun.
Photo: Juergen Faelchle / Shutterstock
Occurs when a toxic substance (allergen) gets on the skin and the epidermis responds with irritation and rashes.Allergens are often:
- Sap or pollen of some plants, such as poison ivy or nettle. Skin reactions to nettle pollen are so common that the characteristic skin rash is called hives.
- Certain metals found in jewelry, hairpins, key rings. Most often, an allergy occurs to nickel, cobalt, chromium, copper.
- Various cosmetic products – from creams to eau de toilette.
- Dyes in cheap clothes.
Allergy to drugs
Photo: ARZTSAMUI / Shutterstock
Rashes and itching can be a side effect of certain medications, such as antibiotics. If you have recently started taking a new medication, see the instructions. At the same time, check if there is any mention of the drug has a photosensitizing (that is, increasing sensitivity to sunlight) effect.
Photo: namtipStudio / Shutterstock
He is also allergic to pollen. This option can be suspected if the rash appeared against the background of other signs of an allergic reaction:
- runny nose; 90,016 90,015 watery eyes;
- obsessive coughing or sneezing.
Photo: Africa Studio / Shutterstock
May manifest itself as hives appearing on different parts of the body, and scarlet rashes on the cheeks (this symptom is more typical for young children).
The most common food allergens are :
- peanuts and hazelnuts;
- fish and crustaceans;
A rash can appear due to bacteria, fungi, viruses that attack the epidermis.
Ringworm, for example, produces round, itchy patches with a bright border. This fungal infection, contrary to stereotypes, can attack not only the scalp, but any other area of the skin.
Photo: Phubes Juwattana / Shutterstock
An example of a viral infection is molluscum contagiosum. This disease makes itself felt with convex reddish-brown and, importantly, hard tubercles with a diameter of 1–5 mm, which can appear anywhere on the body. Despite the name, no shellfish lives under the skin. This is a skin reaction to a virus.
Photo: Lukassek / Shutterstock
What to do if a rash appears on the body
Symptoms for which you need to see a doctor as soon as possible are described above.If you don’t have them, you can try home rash management .
- Keep your skin clean. In the morning, evening, and as it gets dirty, wash it gently with warm water and mild, odorless soap. Until the rash subsides, stop using harsh washcloths and brushes.
- Wear soft, breathable fabrics. The irritated skin must breathe.
- Control the humidity in the room where you are. The optimal value is 40-60%.
- Eliminate potential allergenic foods from your diet.
- If the rash occurs after you start using new makeup, stop using it for a while. And monitor your condition.
- Moisturize your skin. This will reduce itching and help the epidermis heal faster. It is best to apply moisturizers right after showering or bathing. Use only hypoallergenic creams, lotions, or gels.
If the itching is so severe that you cannot forget about it, consult a dermatologist or therapist.Your doctor will recommend antihistamines or over-the-counter ointments to help reduce discomfort.
You should also see a doctor if the rash does not decrease after a day or two, or if you think it is unusual, unexplained, or causes concern. The doctor will make an accurate diagnosis and prescribe the most effective treatment.
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Heat and skin diseases. Recommendations of the chief freelance specialist in dermatovenerology and cosmetology of the Ministry of Health of Chuvashia Nadezhda Krasnova
In hot conditions, there is an increase in the incidence of skin diseases such as prickly heat, pustular skin infections, contact allergic dermatitis, exacerbation of eczema and fungal diseases.
The main cause of these diseases is skin irritation due to increased sweating. In a humid environment, microorganisms multiply faster, their number on the skin increases. The accumulation of particles of dust and dirt, the secretion of the sebaceous and sweat glands can provoke the development of inflammatory processes. At the same time, frequent bathing using detergents that disrupt the normal ph-level of the skin increases the risk of developing skin diseases.
The clinical picture of skin diseases is diverse: rashes can appear on any part of the skin, more often in the skin folds.As a rule, these are small itchy rashes that can merge and be complicated by pustular skin diseases.
In order to prevent it, it is necessary to fight sweating and take proper care of the skin, often change underwear. It is recommended to wear cotton or linen clothing that provides ventilation and prevents excessive perspiration. Shoes should be loose and comfortable. Air baths, frequent ventilation of the premises are useful, in the absence of intolerance – water procedures in the form of baths with decoctions of herbs (oak bark, calendula, chamomile, string).The skin of the folds after the bath must be thoroughly dried, powdered with talcum powder and zinc oxide, you can also wipe it (if there are no wet areas) with a 1% salicylic alcohol solution or a calendula solution (1 tablespoon per glass of boiled water).
When the first signs of the disease appear, you should consult a dermatovenerologist. Only a qualified specialist can prescribe the appropriate therapy.