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Hand Dermatitis | Skin Support

HAND DERMATITIS

What are the aims of this leaflet?  

This leaflet has been written to help you understand more about the causes and treatment of hand dermatitis.  

What is hand dermatitis?

Hand dermatitis is also called hand eczema. It is common and can affect about one in every 20 people. It can start in childhood as part of an in-built tendency to eczema, but is commonest in teenagers and adults. Hand dermatitis may be a short-lived, transient problem. However, in some people, it lasts for years and can have a great impact on daily life.

Who is most likely to get hand dermatitis?

People who have had eczema in childhood (atopic eczema), as well as those who work in jobs with frequent water contact (wet work) have a high risk of getting hand dermatitis.

What causes hand dermatitis?

In many people, hand dermatitis happens because of direct damage to the skin by harsh chemicals as well as irritants, especially soap, detergent and repeated contact with water. This is called irritant contact dermatitis.

Skin contact with allergens such as perfumes, metals, rubber or leather can also cause dermatitis in people with an allergy to these substances. This is called allergic contact dermatitis.

In many cases, however, the cause of a patient’s hand dermatitis is unknown, and there is no identifiable trigger. It is also common for someone to have more than one cause of hand dermatitis, for example a combination of atopic dermatitis and irritant or allergic contact dermatitis.      

Is hand dermatitis hereditary?

No, it is not hereditary; however the tendency to get hand dermatitis can run in families along with atopic dermatitis, asthma and hay fever.

What are the symptoms of hand dermatitis?

The affected areas of skin feel hot, painful, rough, scaly and itchy.  There may be itchy little blisters or painful cracks. This may in turn, result in pain when moving the hand and fingers.

What does hand dermatitis look like?

In hand dermatitis, the skin is inflamed, red and swollen, with a damaged dried-out or scaly surface which makes it look flaky. There may be cracked areas that bleed and ooze. Sometimes small water blisters can be seen on the palms or sides of the fingers. Different parts of the hand can be affected such as the finger webs, fleshy fingertips or centre of the palms. There are several different patterns of hand dermatitis, but these do not usually tell us its cause and the pattern can change over time in one person.

Hand dermatitis may get infected with bacteria called Staphylococcus or Streptococcus. This causes more redness, soreness, crusting, oozing and spots or pimples.        

How is hand dermatitis diagnosed?

Diagnosing hand dermatitis is done by carefully examining the skin.  Examining other body areas will confirm the eczema is isolated to the hands, or suggest a more widespread skin condition is involved.

Identifying a cause for your hand dermatitis involves looking at the pattern of your hand dermatitis and highlighting potential triggers.

Patch testing is used to find out if an allergy (e.g. to metal) is causing allergic contact dermatitis. This is usually done in a dermatology department. This may be one of several causes for a person’s hand dermatitis. The tests are done over several days and on the final day should be read and explained by an expert. Most adults are tested for 50 or more common allergies.  More specific allergens may also be tested depending on the history of a patient’s hand dermatitis.

Can other skin complaints look like hand dermatitis?

Psoriasis of the hands can look similar to dermatitis, especially when there are thick, scaly patches on the palms. Ringworm or fungus infection also causes itchy scaly rashes. These conditions usually start on the feet or groin, but can spread to the hands and nails and sometimes affect only one hand. Skin samples from affected areas can be sent for fungal analysis (mycology) if this needs to be ruled out.

Which occupations often cause hand dermatitis?

Occupations with a high chance of hand dermatitis include cleaners, carers, people who look after young children, chefs, hairdressers, mechanics, doctors, dentists, nurses, florists, machine operators, aromatherapists, beauticians, and construction workers. Any job which involves repeated contact with water or hand washing more than 10 times a day (‘wet work’) has an increased chance of causing hand dermatitis. 

Can hand dermatitis be cured?

In most cases, treatment controls the condition but does not cure it. Early identification and treatment may avoid long standing issues related to hand dermatitis. In people with allergic contact dermatitis, avoiding the allergen(s) may help or even clear the hand dermatitis.

How can hand dermatitis be treated?

Moisturisers (emollients) are an essential part of treating hand dermatitis. They help repair the damaged outer skin and lock moisture inside the skin making it soft and supple again. They should be applied repeatedly throughout the day and whenever the skin feels dry.  They also serve to reduce the risk of secondary bacterial infection.

CAUTION: This leaflet mentions ‘emollients’ (moisturisers). Emollients, creams, lotions and ointments contain oils which can catch fire. When emollient products get in contact with dressings, clothing, bed linen or hair, there is a danger that a naked flame or cigarette smoking could cause these to catch fire. To reduce the fire risk, patients using skincare or haircare products are advised to be very careful near naked flames to reduce the risk of clothing, hair or bedding catching fire. In particular smoking cigarettes should be avoided and being near people who are smoking or using naked flames, especially in bed. Candles may also risk fire. It is advisable to wash clothing daily which is in contact with emollients and bed linen regularly.

Using moisturisers as soap substitutes is very important as they clean the skin without drying and damaging it like liquid soap and bar soap can.

Steroid creams and ointments are the commonest prescribed treatment for hand dermatitis. They relieve symptoms and calm inflamed skin. Stronger strength steroids are usually needed as mild steroids (1% hydrocortisone) do not work on thick skin. They are applied up to twice a day. If they are over-used, there is a risk of skin thinning. However, when used as suggested by your doctor or nurse, topical steroids do not usually cause these problems.

Antihistamine tablets are not often helpful in hand dermatitis. Non-sedating antihistamines are not helpful for most people with eczema. Sedating antihistamines are sometimes taken for a few days when eczema flares up to help sleep. Sedating antihistamines cause drowsiness and should not be taken before driving and using machinery.

Calcineurin inhibitors are creams and ointments used to treat dermatitis instead of steroids. While they may work less well than strong steroids, they do not carry any risk of skin thinning. They can often cause burning or stinging after application.  

Ultraviolet (UV) Therapy is a hospital-based treatment for very severe hand dermatitis. It involves visiting hospital for treatment two or three times a week for about six weeks.

Steroid tablets may be given for a few weeks for a severe flare of hand dermatitis. The dose is usually decreased gradually over a few weeks. Longer-term use is not advisable due to the side effects.

Alitretinoin is based on vitamin A and is prescribed by specialists for severe long-standing hand dermatitis. A treatment course usually lasts up to 6 months.  It must never be taken during pregnancy. For more on the important side-effects associated with alitretinoin, please see the BAD leaflet.

Systemic immunosuppressants are powerful treatments sometimes prescribed by specialists to treat severe hand dermatitis. These medications used include azathioprine, ciclosporinand methotrexate. These treatments are  usually reserved for more severe cases or when other treatment options have failed to control symptoms. They are not suitable for all people. People taking these tablets need to be monitored carefully and have regular blood tests. 

Preventing hand dermatitis – what can I do?

Always use protective gloves at work and at home when in contact with irritating chemicals and water. Wear cotton gloves underneath or chose cotton-lined gloves if you have to work for longer periods of time.

The best choice of glove material (rubber, PVC, nitrile etc) will depend on which chemicals or allergens are being handled. Gloves should be clean and dry inside and not broken.

Some people have boxes of nitrile gloves in the kitchen and bathroom, to help remember to use these when preparing food, cleaning surfaces and washing hair.

If gloves cannot be worn, a barrier cream should be applied before exposure to irritants. After exposure, wash the hands carefully with a soap substitute, rinse, dry thoroughly then moisturise.

The BAD has a leaflet on How to care for your hands.

Where can I get more information about hand dermatitis?

Health and Safety Executive website: www.hse.gov.uk/food/dermatitis.htm

For details of source materials please contact the Clinical Standards Unit ([email protected]).

This leaflet aims to provide accurate information about the subject and is a consensus of the views held by representatives of the British Association of Dermatologists; individual patient circumstances may differ, which might alter both the advice and course of therapy given to you by your doctor.

This leaflet has been assessed for readability by the British Association of Dermatologists’ Patient Information Lay Review Panel

BRITISH ASSOCIATION OF DERMATOLOGISTS
PATIENT INFORMATION LEAFLET
PRODUCED SEPTEMBER 2012
UPDATED JANUARY 2016, AUGUST 2019
REVIEW DATE AUGUST 2022

Differential diagnoses: Hand rashes | GPonline



By Dr Nigel Stollery on the
26 March 2018


Four presentations of hand rashes and clues for their diagnosis, including atopic dermatitis and pompholyx. By Dr Nigel Stollery.

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Atopic dermatitis

Presentation

  • Chronic itchy skin condition
  • Can occur at any age, but less common with increasing age
  • Associated with other atopic conditions, such as asthma, hay fever and rhinitis
  • Often a genetic component
  • Underlying problem is a defect in skin barrier function
  • Stress, viruses and teething in babies common triggers
  • Secondary infection common

Management

  • Emollients are mainstay, but avoidance of triggers important
  • Topical steroids or immunosuppressants usually required
  • Severe cases may require second-line oral therapy

Irritant contact dermatitis

Presentation

  • Eczematous reaction that can occur anywhere on the body when chemicals or physical damage injure skin faster than it can repair itself
  • Severity related to exposure, strength of irritant, environmental factors and individual susceptibility
  • Can affect anyone

Management

  • Specific tests not usually required
  • Management aims to reduce contact with irritants
  • Emollients, topical steroids can be helpful once dermatitis has developed
  • If secondary infection, antibiotics may be required

Allergic contact dermatitis

Presentation

  • Allergic dermatitis secondary to contact with a specific allergen
  • Reaction usually only where contact has occurred
  • Recurrent reaction secondary to each exposure
  • Can affect anywhere on the body; in this case, allergen was latex
  • May occur hours after exposure
  • Affected areas commonly itchy, red and swollen; may blister

Management

  • Patch testing can be useful in identifying allergens
  • Mainstay is avoiding allergens
  • Once dermatitis develops, emollients and topical steroids can help

Pompholyx

Presentation

  • Common type of eczema, affects hands and feet
  • Flares more common in hot weather or at times of stress
  • Can follow fungal infection
  • Occurs as deep-seated crops of blisters
  • Usually associated with burning sensation and intense pruritus

Management

  • Includes cool compresses
  • Emollients can be helpful
  • Potent topical steroids usually required
  • In severe cases, psoralen-UVA or systemic steroids may help
  • In chronic cases, methotrexate, dapsone or azathioprine may help

Dr Stollery is a GP in Leicestershire

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Types, Symptoms, Treatments, & More

What Are Rashes?

Rashes are abnormal changes in skin color or texture. They usually result from skin inflammation, which can have many causes.

There are many types of rashes, including eczema, granuloma annulare, lichen planus, and pityriasis rosea.

Eczema

Eczema is a general term that describes several different conditions in which skin is inflamed, red, scaly, and itchy. Eczema is a common skin condition, and atopic dermatitis (also called atopic eczema) is one of the most common forms of eczema.

Eczema can affect adults or children. The condition isn’t contagious. View a slideshow to get an overview on eczema.

Causes

We don’t know for sure what causes atopic eczema, but the condition often affects people with a family history of allergies. If you have eczema, you may also have hay fever and/or asthma, or have family members with those conditions.

Some things can trigger a flare-up of eczema or make eczema worse, but they don’t cause the condition. Eczema triggers include stress, skin irritants (including soaps, skin care products, or some fabrics), allergens, and climate/environment. Learn more about the link between allergies and eczema.

Symptoms

The way eczema looks can vary from person to person. In adults, eczema most often affects the hands, elbows, and “bending” areas like the inside of the elbows and back of your knees. In young children, eczema often shows up inside the elbows, behind the knees, and on the face, back of the neck, and scalp. Signs and symptoms of atopic eczema include:

  • Itchiness
  • Skin redness
  • Dry, scaly, or crusted skin that might become thick and leathery from long-term scratching
  • Formation of small, fluid-filled blisters that might ooze when scratched
  • Infection of the areas of broken skin

Diagnosis

To diagnose atopic eczema, the doctor will check your skin and ask about your symptoms. They might test an area of scaly or crusty skin to rule out other skin diseases or infections. Find out more on the symptoms and diagnosis of eczema.

Treatment

You can treat eczema with moisturizers that are fragrance-free and contain ingredients such as ceramides, glycerin, and mineral oil. Medications include over-the-counter creams and ointments containing the steroid hydrocortisone (for example, Cortizone-10, Cort-Aid, Dermarest Eczema, Neosporin Eczema). These products may help control the itching, swelling, and redness linked to eczema. Prescription-strength cortisone creams, as well as cortisone pills and shots, are also used for more severe cases.

For people with mild to moderate eczema, topical immunomodulators (TIMs) can help. TIMS — including brand name products Elidel and Protopic — work by changing the body’s immune response to allergens, preventing flare-ups.

Crisaborole (Eucrisa) is an ointment for mild to moderate psoriasis in those 2 and older.

Dupilumab (Dupixent) is an injectable monoclonal antibody used in patients with moderate to severe atopic dermatitis. It clears the itch quickly in most patients.

Other drugs that might be used for people with eczema include antibiotics (to treat infected skin) and antihistamines (to help control itching).

Phototherapy is another treatment that helps some people with eczema. The ultraviolet light waves found in sunlight have been shown to help treat certain skin disorders, including eczema. Phototherapy uses ultraviolet light — either ultraviolet A (UVA) or ultraviolet B (UVB) — from special lamps to treat people with severe eczema.

Risks linked to phototherapy include burning (usually resembling a mild sunburn), dry skin, itchy skin, freckling, and possible premature aging of the skin. Your health care professionals will work with you to lessen any risks. Get more details about treatments for eczema.

Prevention

There’s no way to prevent atopic eczema, but you can do things to improve your symptoms:

  • Reduce stress
  • Avoid scratchy materials (for example, wool) and chemicals such as harsh soaps, detergents, and solvents
  • Moisturize often
  • Avoid sudden changes in temperature or humidity
  • Avoid situations that cause sweating and overheating

Read more on how to prevent eczema flare-ups​​​​​​​.

 

Granuloma Annulare

Granuloma annulare is a chronic skin condition that consists of a circular-shaped rash with reddish bumps (papules).

Most often, the condition affects children and young adults. Granuloma annulare is slightly more common in girls and usually is seen in people who are otherwise healthy.

Causes

We don’t know what causes granuloma annulare.

Symptoms

People who have granuloma annulare usually notice one or more rings of small, firm bumps over the backs of their forearms, hands, or feet. The rash may be mildly itchy.

Diagnosis

Your doctor can diagnose you. They might use a skin biopsy to confirm you have granuloma annulare.

Treatment

Treatment of granuloma annulare usually isn’t necessary, except for cosmetic reasons. In some cases, steroid creams or ointments can help the bumps disappear. Some doctors may decide to freeze the lesions with liquid nitrogen or to inject steroids directly into the rings of bumps. Ultraviolet light therapy or oral drugs can be used in serious cases.

See a photo of what granuloma annulare looks like.

Lichen Planus

Lichen planus is a common skin disorder that produces shiny, flat-topped bumps. They often have an angular shape and a reddish-purplish color. Lichen planus can show up anywhere on the skin but often affects the insides of your wrists and ankles, your lower legs, your back, and your neck. Some people have lichen planus inside their mouth, genital region, scalp, and nails. Thick collections of bumps may occur, especially on the shins.

Lichen planus most often affects adults ages 30-70. It isn’t common in very young or elderly people.

Causes

Doctors think lichen planus is an autoimmune condition, meaning your body’s immune system attacks its own tissues. But they don’t know what causes it. Sometimes lichen planus results from a triggering agent such as hepatitis B or hepatitis C. Doctors call that a lichenoid reaction.

If you’re allergic to medications to treat high blood pressure, heart disease, and arthritis, you could get a lichen planus-type rash. Lichen planus isn’t contagious.

Symptoms

Signs and symptoms of the condition include shiny, flat-topped bumps that are purple or a reddish-purplish color. It’s often itchy. When it shows up on your scalp, lichen planus can lead to hair loss. Lichen planus of the nails can cause brittle or split nails.

Diagnosis

A doctor can diagnose lichen planus by the way it looks or with the use of a skin biopsy. For this procedure, they’ll take a small bit of skin from the affected area and send it to a lab for testing.

Treatment

Lichen planus can’t be cured, but you can treat the symptoms with anti-itch products like antihistamines (for example, Benadryl, or diphenhydramine). If lichen planus affects only a small part of the body, you can apply medicated cream to the affected area. In more severe cases, doctors might prescribe steroid shots, prednisone, or other drugs that suppress your immune system. They might also give you retinoids or try light therapy.

View a slideshow to see photos of lichen planus and other skin reactions.

Pityriasis Rosea

Pityriasis rosea is a common skin rash that usually is mild. The condition often begins with a large, scaly, pink patch of skin on your chest or back. Next you’ll notice one patch of pink skin quickly followed by more. Your skin will be itchy and red or inflamed. The number and sizes of spots can vary.

Causes

We don’t know what causes pityriasis rosea. But there is evidence that suggests pityriasis rosea may be caused by a virus because the rash resembles certain viral illnesses. The rash doesn’t seem to spread from person to person.

Symptoms

The primary symptom of pityriasis rosea is that large, scaly, pink area of skin followed by more itchy, inflamed, or reddened patches. Pityriasis rosea affects the back, neck, chest, abdomen, upper arms, and legs. The rash can differ from person to person.

Diagnosis

A doctor can usually diagnose pityriasis rosea by looking at it. They may do blood tests, scrape your skin, or do a skin biopsy to rule out other skin conditions.

Treatment

If your case is mild, you may not need treatment. Even more serious cases sometimes go away on their own. Oral antihistamines (like diphenhydramine), over-the-counter medications you rub on your skin, and prescription steroids can help soothe the itch.

Sores may heal faster with some exposure to sunlight or ultraviolet light. Don’t get too much sun, though. In most cases, pityriasis rosea goes away within 6-12 weeks.

See a photo of what pityriasis rosea looks like.

A mysterious rash on a woman’s hands and lips stumped specialists

At first the rash didn’t bother her, said Julia Omiatek, recalling the itchy red bumps that suddenly appeared one day on her palm, near the base of her first and third fingers. It was January 2013 — the dead of winter in Columbus, Ohio — so when the area reddened and cracked a few weeks later, she assumed her problem was simply dry skin and slathered on some cream.

Omiatek, then 35, had little time to ponder the origin of her problem. An occupational therapist who works with adult patients, she was also raising two children younger than 3. A few weeks later when her lips swelled and the rash appeared on her face, she decided it was time to consult her dermatologist.

Skin problems were nothing new; Omiatek was so allergic to nickel that her mother had had to sew cloth inside her onesies to prevent the metal snaps from touching her skin and causing a painful irritation. Over the years she had learned to avoid nickel and contend with occasional, inexplicable rashes that seemed to clear up when she used Elidel, a prescription cream that treats eczema.

But this time the perpetually itchy rash didn’t go away, no matter what she did. Over the course of 11 months, she saw four doctors, three of whom said they didn’t know what was causing the stubborn eruption that eluded numerous tests. The fourth specialist took one look at her hand and figured it out.

“The location was a tip-off,” said Matthew Zirwas, an assistant professor of dermatology at the Ohio State University Wexner Medical Center who specializes in treating unexplained rashes. Omiatek’s case was considerably less severe than that of many of the approximately 300 other patients he has treated for the same problem.

Unprepared for multiple visits to a dermatology clinic, Julia Omiatek thought she could determine the cause of her vexing rash on her own. Eight months later, she changed her mind. (Family Photo)

“I can’t tell you the number of people who come into my office with a horrible, weeping, itchy rash that’s ruining their lives; it’s all they can think about,” he said. “And when I tell them the cause, they just burst into tears” of relief.

During her first visit to the dermatologist in February 2013, Omiatek said that the doctor looked at her hand and posed a series of questions. He knew she had a 7-month-old baby and asked whether she might be washing her hands too much. Omiatek said she wasn’t and was slightly put off by his next question: “Are you stressed?”

“Nooo,” she said she replied.

The doctor told her he didn’t know what was causing the rash or intermittent lip-swelling, but advised her to continue using the prescription cream.

When she asked him whether her nickel allergy might be responsible — there is nickel in some foods, including chocolate and bran — he told her that might be the cause. Omiatek began avoiding foods containing nickel; her swollen lips improved somewhat, but the rash on her hand did not.

A month later, she decided to consult a family medicine physician who specializes in personalized nutrition. Omiatek said she was increasingly convinced she had a food allergy — why else would her lips swell? — and the doctor had come highly recommended. But he had no new ideas about what she might avoid eating. A month later, Omiatek went to an allergist.

The allergist performed an extensive battery of prick tests, in which tiny amounts of allergens are placed on and just under a patient’s skin to see if they trigger a reaction. Omiatek said she was tested for varieties of nuts, fruits and other foods as well as grasses and pollens; other than confirming her known allergies to mold, nickel and dandelions, the tests revealed nothing. The allergist suggested that Omiatek see Zirwas, who heads the Contact Dermatitis Center at OSU.

Omiatek said she called the clinic and was told that patients must commit to three appointments in a single week; the first two would take about two hours each.

Given her work schedule and responsibilities at home, Omiatek decided that she didn’t have the time; she felt confident that if she kept a diary of what she ate, she could determine what was causing her vexing skin problem.

Poison ivy toilet paper?

But eight months later, Omiatek still had the rash and no answer. She scheduled a series of appointments with Zirwas and was told to bring every product that touched her skin, including shampoos, face creams, sunscreen, soap, laundry detergent and makeup. The chemicals in the products would form the basis for patch tests Zirwas would administer to determine whether Omiatek was allergic to any of the ingredients.

As she trundled her large shopping bag brimming with bottles and vials into the clinic, Omiatek had second thoughts. “I remember thinking, ‘Oh, my God, this is ridiculous,” she said, as her overloaded bag ripped open in the waiting room.

Zirwas said he remembers examining Omiatek’s palm and feeling certain he knew what the culprit would prove to be. “I have seen this particular scenario enough over the past five years,” he said.

But first he had to be sure. Small amounts of chemicals in the products Omiatek used would be applied to the skin on her back and covered with a small patch that would be left in place for several days; an itchy rash or other reaction underneath the patch signaled an allergy. Unlike allergies to foods, animals or natural substances, which tend to show up immediately, delayed reactions to chemicals contained in personal-care products and laundry detergents typically occur 12 hours or even a day or two after exposure, just as poison ivy does.

After 24 hours wearing 116 patches, Omiatek said, her “back started to itch really bad.”

At her second appointment Zirwas examined her back, confirming his hunch: The only strong reaction Omiatek displayed was to a chemical called methyllisothiazolinone, MI for short, which is used in high concentration in hundreds of beauty and personal care products.

In Omiatek’s case, MI was in the new brand of “sensitive” baby wipes she had begun using a few weeks before the hand rash erupted. The pattern of the rash, which was on her right, dominant hand, matched the way one would use a wipe. MI was also in the dishwashing soap she used as well as in her soap and shampoo.

Luckily for Omiatek, she did not use premoistened personal wipes containing MI, as have scores of Zirwas’s patients. Most, he said, arrive in his office after months of misery. Some were convinced they had a horrible sexually transmitted disease; in fact, the rash was an allergic reaction to the wipes they had been using.

“It’s like wiping with poison ivy leaves,” Zirwas said. “I cannot tell you the number of people just bawling in my office because they have a horribly itchy weeping rash around their anus. They’ve been to doctor after doctor and no one could figure it out.” Zirwas estimates that about half of the approximately 300 MI allergy patients he has seen were using wipes. Cases of allergic reactions have also been reported in babies and young children who had been exposed to baby wipes containing the preservative, and outbreaks have been reported in Europe.

Unlike shampoo or soap that is rinsed off, the substances in toilet wipes remain on the skin, in a part of the body where evaporation does not occur. “It gets driven into the skin, perpetuating the problem,” said Zirwas, noting that it takes months for the rash to clear entirely after a patient stops using the product.

Zirwas said that manufacturers are aware of the problem, and some have pledged to remove the chemical from their products. In a statement, Kimberly-Clark, which says that its products are safe, recently introduced an MI-free line of baby wipes. The company has pledged to remove the preservative from all its wipes by the end of this year.

The concentration of MI in some personal-care products was increased about five years ago to replace other preservatives, including formaldehyde, which have been linked to health problems. “People thought it was going to be” an effective replacement, Zirwas said, “but around two or three years ago, we started seeing an incredible increase in the number of people allergic to it.”

Omiatek said she was surprised when Zirwas told her the cause of her rash. “I said, ‘Really? I would never have suspected baby wipes.’ You put them on a baby, so I figured they’d be exempt from problems.” She also learned she was allergic to the brand of “sensitive baby sunscreen” she had been using on her children, although neither child developed a rash.

Avoiding MI is easy, Zirwas said; it is listed as an ingredient on a product’s label. Omiatek said she is taking no chances. She now reads labels carefully and has stopped using all baby wipes in an attempt to avoid “funky chemicals.”

Submit your solved medical mystery to [email protected]. Read previous mysteries here.

Rash, Age 11 and Younger

Does your child have a rash?

How old are you?

Less than 3 months

Less than 3 months

3 to 5 months

3 to 5 months

6 months to less than 3 years

6 months to less than 3 years

3 to 11 years

3 to 11 years

12 years or older

12 years or older

Are you male or female?

Why do we ask this question?

The medical assessment of symptoms is based on the body parts you have.

  • If you are transgender or non-binary, choose the sex that matches the body parts (such as ovaries, testes, prostate, breasts, penis, or vagina) you now have in the area where you are having symptoms.
  • If your symptoms aren’t related to those organs, you can choose the gender you identify with.
  • If you have some organs of both sexes, you may need to go through this triage tool twice (once as “male” and once as “female”). This will make sure that the tool asks the right questions for you.

Does your child have a tick bite?

Has your child been bitten or stung by an insect or spider?

Yes

Insect or spider bite or sting

No

Insect or spider bite or sting

Does your baby seem sick?

A sick baby probably will not be acting normally. For example, the baby may be much fussier than usual or not want to eat.

How sick do you think your baby is?

Extremely sick

Baby is very sick (limp and not responsive)

Sick

Baby is sick (sleepier than usual, not eating or drinking like usual)

Could your child be having a severe allergic reaction?

This is more likely if your child has had a bad reaction to something in the past.

Yes

Possible severe allergic reaction (anaphylaxis)

No

Possible severe allergic reaction (anaphylaxis)

Have tiny red or purple spots or bruises appeared suddenly?

Yes

Sudden appearance of red or purple spots or bruising

No

Sudden appearance of red or purple spots or bruising

Does your child feel light-headed and dizzy, like he or she is going to faint?

It’s normal for some people to feel a little light-headed when they first stand up. But anything more than that may be serious.

Yes

Feels faint or light-headed

No

Feels faint or light-headed

Is your child bleeding now?

Yes

Abnormal bleeding now present

No

Abnormal bleeding now present

Are there red streaks leading away from the area or pus draining from it?

Does your child have diabetes, a weakened immune system, or any surgical hardware in the area?

“Hardware” includes things like artificial joints, plates or screws, catheters, and medicine pumps.

Yes

Diabetes, immune problems, or surgical hardware in affected area

No

Diabetes, immune problems, or surgical hardware in affected area

Do you think that the rash may have been caused by abuse or neglect?

Yes

Rash may be caused by abuse or neglect

No

Rash may be caused by abuse or neglect

Do you think your baby has a fever?

Did you take your child’s temperature?

This is the only way to be sure that a baby this age does not have a fever. If you don’t know the temperature, it’s safest to assume the baby has a fever and needs to be seen by a doctor. Any problem that causes a fever at this age could be serious. Rectal temperatures are the most accurate. Taking an axillary (armpit) temperature is also an option.

Is it 38°C (100.4°F) or higher, taken rectally?

This would be an axillary temperature of 37.5°C (99.5°F) or higher.

Yes

Temperature at least 38°C (100.4°F) taken rectally

No

Temperature at least 38°C (100.4°F) taken rectally

Do you think your child has a fever?

Did you take your child’s temperature?

How high is the fever? The answer may depend on how you took the temperature.

High: 40°C (104°F) or higher, oral

High fever: 40°C (104°F) or higher, oral

Moderate: 38°C (100.4°F) to 39.9°C (103.9°F), oral

Moderate fever: 38°C (100.4°F) to 39.9°C (103.9°F), oral

Mild: 37.9°C (100.3°F) or lower, oral

Mild fever: 37.9°C (100.3°F) or lower, oral

How high do you think the fever is?

Moderate

Feels fever is moderate

Mild or low

Feels fever is mild

How long has your child had a fever?

Less than 2 days (48 hours)

Fever for less than 2 days

From 2 days to less than 1 week

Fever for more than 2 days and less than 1 week

1 week or longer

Fever for 1 week or more

Does your child have a rash that looks like a sunburn?

Does your child have a health problem or take medicine that weakens his or her immune system?

Yes

Disease or medicine that causes immune system problems

No

Disease or medicine that causes immune system problems

Does the rash have blisters?

Does the rash cover:

A rash that covers most of the body is on both sides of the body and on most of the legs, arms, back, or belly. A rash in one area may be just one small patch. Or it may be two or three small patches that cover a small area.

Most of the body?

Rash is all over the body

Or is it in one area?

Rash is in one area of the body

Is the rash a red, peeling rash that leaves very large areas raw and oozing fluid?

Yes

Red, peeling rash with large areas that are raw and ooze fluid

No

Red, peeling rash with large areas that are raw and ooze fluid

Does your child have a sore throat?

Certain illnesses can cause a rash and a sore throat. Your child may need to be seen sooner if he or she has both.

Are there sores or a rash inside the mouth or nose or in the eyes?

Yes

Rash or sores in mouth, nose, or eyes

No

Rash or sores in mouth, nose, or eyes

Has your child had a sore on the skin for more than a week?

Yes

Sore on the skin for more than 1 week

No

Sore on the skin for more than 1 week

Does your child have a new rash in the shape of a band or a strip on just one side of the body?

Yes

New band-shaped rash on one side

No

New band-shaped rash on one side

Do you think that a medicine could be causing the rash?

Think about whether the rash appeared after you began using a new medicine or a higher dose of a medicine.  

Yes

Medicine may be causing rash

No

Medicine may be causing rash

Is the itching severe?

Severe means that you are scratching so hard that your skin is cut or bleeding.

Has the itching interfered with sleeping or normal activities for more than 2 days?

Yes

Itching has disrupted sleep or normal activities for more than 2 days

No

Itching has disrupted sleep or normal activities for more than 2 days

Does the rash produce a honey-coloured drainage that dries into crusts and covers an area larger than 5.1 cm (2 in.)?

Yes

Honey-coloured drainage that dries into crusts and covers more than 5.1 cm (2 in.)

No

Honey-coloured drainage that dries into crusts and covers more than 5.1 cm (2 in.)

Has your child had a rash for more than 2 weeks?

Yes

Rash for more than 2 weeks

No

Rash for more than 2 weeks

Many things can affect how your body responds to a symptom and what kind of care you may need. These include:

  • Your age. Babies and older adults tend to get sicker quicker.
  • Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
  • Medicines you take. Certain medicines and natural health products can cause symptoms or make them worse.
  • Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
  • Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.

Try Home Treatment

You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.

  • Try home treatment to relieve the symptoms.
  • Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.

Symptoms of infection may include:

  • Increased pain, swelling, warmth, or redness in or around the area.
  • Red streaks leading from the area.
  • Pus draining from the area.
  • A fever.

If you’re not sure if a child’s fever is high, moderate, or mild, think about these issues:

With a high fever:

  • The child feels very hot.
  • It is likely one of the highest fevers the child has ever had.

With a moderate fever:

  • The child feels warm or hot.
  • You are sure the child has a fever.

With a mild fever:

  • The child may feel a little warm.
  • You think the child might have a fever, but you’re not sure.

Certain health conditions and medicines weaken the immune system’s ability to fight off infection and illness. Some examples in children are:

  • Diseases such as diabetes, cystic fibrosis, sickle cell disease, and congenital heart disease.
  • Steroid medicines, which are used to treat a variety of conditions.
  • Medicines taken after organ transplant.
  • Chemotherapy and radiation therapy for cancer.
  • Not having a spleen.

Temperature varies a little depending on how you measure it. For children up to 11 years old, here are the ranges for high, moderate, and mild according to how you took the temperature.

Oral (by mouth) temperature

  • High: 40° C (104° F) and higher
  • Moderate: 38° C (100.4° F) to 39.9° C (103.9° F)
  • Mild: 37.9° C (100.3° F) and lower

A forehead (temporal) scanner is usually 0. 3° C (0.5° F) to 0.6° C (1° F) lower than an oral temperature.

Ear or rectal temperature

  • High: 40.5° C (104.9° F) and higher
  • Moderate: 38.5° C (101.3° F) to 40.4° C (104.7° F)
  • Mild: 38.4° C (101.1° F) and lower

Armpit (axillary) temperature

  • High: 39.8° C (103.6° F) and higher
  • Moderate: 37.8° C (100° F) to 39.7° C (103.5° F)
  • Mild: 37.7° C (99.9° F) and lower

Note: For children under 5 years old, rectal temperatures are the most accurate.

Sudden tiny red or purple spots or sudden bruising may be early symptoms of a serious illness or bleeding problem. There are two types.

Petechiae (say “puh-TEE-kee-eye”):

  • Are tiny, flat red or purple spots in the skin or the lining of the mouth.
  • Do not turn white when you press on them.
  • Range from the size of a pinpoint to the size of a small pea and do not itch or cause pain.
  • May spread over a large area of the body within a few hours.
  • Are different than tiny, flat red spots or birthmarks that are present all the time.

Purpura (say “PURR-pyuh-ruh” or “PURR-puh-ruh”):

  • Is sudden, severe bruising that occurs for no clear reason.
  • May be in one area or all over.
  • Is different than the bruising that happens after you bump into something.

Abnormal bleeding means any heavy or frequent bleeding or any bleeding that is not normal for you. Examples of abnormal bleeding include:

  • Nosebleeds.
  • Vaginal bleeding that is different (heavier, more frequent, at a different time of month) than what you are used to.
  • Rectal bleeding and bloody stools.
  • Bloody or pink urine.
  • Gums that bleed easily when you eat or gently brush your teeth.

When you have abnormal bleeding in one area of your body, it’s important to think about whether you have been bleeding anywhere else. This can be a symptom of a more serious health problem.

Symptoms of a severe allergic reaction can start within minutes of eating or being exposed to an allergen. While symptoms usually occur within 2 hours, in rare cases the time frame can vary up to several hours after exposure. Do not ignore early symptoms. When a reaction begins, it is important to respond right away.

Symptoms of a severe allergic reaction can vary from person to person. The same person can have different symptoms each time they have a severe allergic reaction. Symptoms can include any of the following:

    • Skin: hives, swelling (face, lips, tongue), itching, warmth, redness
    • Respiratory (breathing): coughing, wheezing, shortness of breath, chest pain or tightness, throat tightness, hoarse voice, nasal congestion or hay fever-like symptoms (runny, itchy nose and watery eyes, sneezing), trouble swallowing
    • Gastrointestinal (stomach): nausea, pain or cramps, vomiting, diarrhea
    • Cardiovascular (heart): paler than normal skin colour/blue colour, weak pulse, passing out, dizziness or lightheadedness, shock
    • Other: anxiety, sense of doom (the feeling that something bad is about to happen), headache, uterine cramps, metallic taste

A severe reaction can take place without hives, so make sure to look out for all of the signs of an allergic reaction.

Symptoms of serious illness in a baby may include the following:

  • The baby is limp and floppy like a rag doll.
  • The baby doesn’t respond at all to being held, touched, or talked to.
  • The baby is hard to wake up.

Symptoms of serious illness may include:

  • A severe headache.
  • A stiff neck.
  • Mental changes, such as feeling confused or much less alert.
  • Extreme fatigue (to the point where it’s hard for you to function).
  • Shaking chills.

Many prescription and non-prescription medicines can cause a rash. A few common examples are:

  • Antibiotics.
  • ASA, ibuprofen (Advil, Motrin), and naproxen (Aleve).
  • Pain medicines, such as codeine.
  • Seizure medicines.

Shock is a life-threatening condition that may occur quickly after a sudden illness or injury.

Babies and young children often have several symptoms of shock. These include:

  • Passing out (losing consciousness).
  • Being very sleepy or hard to wake up.
  • Not responding when being touched or talked to.
  • Breathing much faster than usual.
  • Acting confused. The child may not know where he or she is.

A baby that is extremely sick:

  • May be limp and floppy like a rag doll.
  • May not respond at all to being held, touched, or talked to.
  • May be hard to wake up.

A baby that is sick (but not extremely sick):

  • May be sleepier than usual.
  • May not eat or drink as much as usual.

Make an Appointment

Based on your answers, the problem may not improve without medical care.

  • Make an appointment to see your doctor in the next 1 to 2 weeks.
  • If appropriate, try home treatment while you are waiting for the appointment.
  • If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.

Seek Care Today

Based on your answers, you may need care soon. The problem probably will not get better without medical care.

  • Call your doctor today to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don’t have one, seek care today.
  • If it is evening, watch the symptoms and seek care in the morning.
  • If the symptoms get worse, seek care sooner.

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

  • Call your doctor now to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don’t have one, seek care in the next hour.
  • You do not need to call an ambulance unless:
    • You cannot travel safely either by driving yourself or by having someone else drive you.
    • You are in an area where heavy traffic or other problems may slow you down.

Call 911 Now

Based on your answers, you need emergency care.

Call 911 or other emergency services now.

Sometimes people don’t want to call 911. They may think that their symptoms aren’t serious or that they can just get someone else to drive them. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital.

Rash, Age 12 and Older

Tick Bites

Insect Bites and Stings and Spider Bites

Rashes on Children: When Should I Worry?

Childhood rashes are common, but that doesn’t mean they don’t freak you out any less as a parent. While most rashes do get better on their own, you may not be sure, especially if your child’s rash is accompanied by a fever or other symptoms.

“Rashes can be caused or associated with a variety of conditions, from mild conditions like heat rashes to serious conditions like meningitis,” said Nurul Hariadi, MD, a pediatric infectious diseases specialist at Banner Health Center. “Because of this, it’s important to know which should prompt a call to your child’s doctor or a visit to the ER.”

A good rule of thumb to remember is that a local rash is most likely caused by skin contact, exposure to certain materials or substances, and sometimes germs, such as diaper rash or an insect bite. A widespread rash is usually associated with a cause that affects the entire body such as measles.

Because many illnesses cause rashes, we put together a list of eight of the most common ones that occur in children, signs and symptoms that should prompt a visit to your child’s doctor or the ER, and an illustrative guide to keep on hand for quick reference.

8 Common Types of Childhood Rashes

Roseola

Roseola is one of the most common viral infections among children 6 months to 3 years of age. It starts with a fever for 2 to 3 days, followed by a rash after the fever is gone. Once the rash appears, your child is usually fine and doesn’t require treatment.

Fifth Disease

Fifth disease, often called slapped cheek disease, is a common childhood infection caused by parvovirus. The symptoms are usually mild and include fever, upset stomach, headache and a rash that looks like the cheeks were slapped. It may be followed by a lacelike rash on the stomach, legs or arms. Older children or adults may experience joint pain. The virus clears up on its own, but your child may require pain reliever to treat symptoms.

Hand, Foot & Mouth Disease

Hand, foot and mouth disease is caused by a group of viruses called enteroviruses and is a self-limiting disease, which means it will resolve without specific medication. It is spread by saliva, nasal mucus or fluid from an erupted blister. It causes tiny bumps, blisters or sores on the hands, feet, diaper area and in the mouth. It may also be associated with a fever and sore throat. If your child is able to take and keep fluids down and is active, you may observe them at home after discussing it with their doctor or triage nurse.

Impetigo

Impetigo is one of the most common superficial bacterial skin infections in children. It usually appears as red bumps on the face that develop honey-colored crusts when they burst. Depending on the severity, it may require an antibiotic that is applied to the skin or taken by mouth.

MRSA

MRSA skin infection is caused by a type of Staphylococcus bacteria called Staphylococcus aureus that unfortunately causes infections that don’t respond well to antibiotics that treat less resistant S. aureus. Therefore, your child may need a different antibiotic. Recurrent boils can form and may require incision and drainage. Your child’s doctor may need to send the pus to a lab to check for MRSA.

Ringworm

Ringworm, or tinea corporis, is one of the most common fungal skin infections in children. It is scaly, red and itchy and may sometimes look like eczema. Depending on the location (skin versus scalp or nails), it may need antifungal medication that is applied on the skin or taken by mouth.

Scarlet Fever

Scarlet fever, or scarlatina, is a bacterial infection that develops in some children who have Strep throat. It is most common in children 5 to 15 years old. Symptoms include a scarlet-colored rough rash that covers most of the body and feels like sandpaper, sore throat and high fever. Antibiotic is given to treat the illness.

Atopic Dermatitis

Atopic dermatitis or eczema is not an infectious disease, it is a chronic skin condition. About 5% to 20% of children may have it, but many outgrow it by late childhood. Depending on age, it can appear on different areas of the body. Common symptoms are red, inflamed and dry, itchy skin patches. Treatment will depend on your child’s symptoms and age.

Got Questions? Call Your Doctor

If your child has an unexplained rash, don’t hesitate to call their doctor. It’s better to talk to them about a rash (even if it ends up being nothing serious) than missing symptoms of a serious illness. To schedule an appointment, visit bannerhealth.com.

If you can’t reach the doctor, you can also call the Banner Nurse Now line at 844-259-9494 for free health care advice 24/7.


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Rashes Could Be ‘Key Sign’ Of Covid-19. Here’s What They Look Like

Rashes should be considered a “key diagnostic sign” of Covid-19, according to a study, which found 8% of people who test positive for the virus have some form of rash.

A team of researchers from the Covid Symptom Study surveyed 12,000 people who had skin rashes, as well as suspected or confirmed Covid-19.

They asked for images of rashes from survey respondents, especially people of colour, who are currently under-represented in dermatology resources.

An example of Covid fingers

In some cases the rash can occur on its own, the study found, without any other symptoms of the virus such as a continuous cough, fever, or loss of smell. Almost one in five (17%) who had tested positive for coronavirus reported a rash as the first symptom of the disease. Among those who reported a rash – and were confirmed as having coronavirus – 21% said it was their only symptom.

The NHS only lists three symptoms of coronavirus. These are: a high temperature, new and continuous cough, and a loss or change to your sense of smell or taste. Rashes aren’t widely considered to be a symptom of the virus.

We asked researchers from the Covid Symptom Study to share photos of the rashes that have regularly showed up in coronavirus patients.

Key rashes to look out for

There are three main types of rash the researchers found showed up in patients.

The first is a hive-type rash (also referred to as urticaria), where raised bumps can suddenly appear on the skin – these can come and go quite quickly over hours and can be very itchy. Think: nettle rash.

Urticaria on a patient’s torso.An example of urticaria in a Covid-19 patient.

Urticaria rashes can appear quite early on in the infection, but also last a long time, said researchers.

It often starts with intense itching on the palm of your hands or soles of your feet, but it can also cause swelling of the lips and eyelids.

An example of urticaria linked to Covid-19.

The second type of rash seen in the Covid Symptom Study is a prickly heat-type rash – a bit like chickenpox – where small, itchy red bumps can appear anywhere on the body, but particularly the elbows and knees, as well as the backs of the hands and feet.

This type of rash can persist for days or weeks, said researchers.

A chickenpox-type rash on the abdomen of a Covid patient.A rash on the arm of a Covid patient.A rash on the back of a Covid patient.

The third type of rash, known as Covid fingers and toes (sometimes described as chilblains), is where red and purple bumps appear on the fingers or toes.

These bumps may be sore, but not usually itchy. This type of rash is most specific to Covid-19 and is more common in younger people with the disease. It also tends to present later on in someone’s illness.

An example of Covid fingersAn example of Covid fingers

A separate study of patients in Spain found that, in addition to these rashes, some patients experienced a type similar to pityriasis rosea, a skin condition, which presents as a pink, scaly rash. There’s a theory this type of rash may be caused by a viral infection, so the appearance of it would make sense.

“Many viral infections can affect the skin, so it’s not surprising we’re seeing these rashes in Covid-19,” says Covid Symptom Study author Dr Veronique Bataille, consultant dermatologist at St Thomas’ Hospital and King’s College London (KCL).

“It’s important people know that in some cases, a rash may be the first or only symptom of the disease. If you notice a new rash, you should take it seriously by self-isolating and getting tested as soon as possible.”

The current swab tests for coronavirus should ideally be taken within three days of noticing symptoms – after five days they might not work. If you do notice a rash, you could also call your GP surgery or pharmacy who should be able to advise on possible treatments and what to do next.

“It’s important people know that in some cases, a rash may be the first or only symptom of the disease”

– Dr Veronique Bataille

Dr Tanya Bleiker, president of the British Association of Dermatologists (BAD), says such studies play an important role in building our understanding of the disease as a whole – especially as in the early days of the Covid-19 pandemic, the various skin manifestations of the disease were “poorly understood”.

BAD is working with the Covid Symptom Study team to develop a website that will host a library of the different skin manifestations of the virus. Members of the public should be cautious about self-diagnosing Covid-19 based on skin symptoms, said BAD, as rashes and other skin lesions are common and hard to differentiate between without expertise.

“We hope that this will be of benefit to healthcare professionals as well as the public who may be unaware of skin symptoms which would warrant self-isolation,” says Dr Bleiker.

90,000 Why do rashes occur on the palms

A rash can appear all over the body, including the palms. During the day, your hand comes into contact with different people, the environment, and other stimuli that can trigger a reaction. Analyzing the symptoms and causes of a rash on the palms can help a doctor diagnose your condition.

8 causes of rashes on the palms

A rash is a symptom that can cause itching, burns, or swelling of the skin.While a rash is not always indicative of a more serious condition, it can be a sign of infection or exposure to an allergen.

There are a number of conditions that can trigger a rash in your palm. Some of the most common:

1. Allergic reaction

Food or drug allergies can cause an allergic reaction, which can manifest as a rash, itching, blistering or even hives.

Other common symptoms that may accompany a rash on the palms include:

  • vomiting;
  • 90,025 diarrhea;

    90,025 itching in the mouth;

    90 025 shortness of breath;

    90,025 edema;

    90 025 difficulty swallowing;

  • anaphylactic shock.

Severe allergic reaction and anaphylactic shock are considered a medical emergency. You should see your doctor immediately if you have these or any more serious symptoms.

2. Skin dryness

During the cold season, the weather can dry out the skin, causing itching and flaking of the skin of the hands. This can also directly touch the palms.

Eczema and certain medications also sometimes cause dry skin and rashes.Scratching your palms can make your symptoms worse.

3. Ringworm

This fungal infection is a common but treatable disease. Ringworm is a skin infection that appears as a ring-shaped rash on various parts of the body. But on the palms, the characteristic ring-shaped pattern does not develop.

In addition to a rash on the skin of your palms, you may experience:

  • dryness;
  • deep cracks;
  • coarsening;
  • inflammation.

4. Contact dermatitis

Contact dermatitis is a form of eczema that causes a rash when your skin or hands touch an irritant. A skin rash develops within 48 hours if the reaction to such an irritant appears for the first time. If you are in contact with the trigger again, the re-reaction to it may develop more quickly.

Contact dermatitis usually occurs after contact with:

You may also get rashes on your palms from touching cleaning products, bleach, and certain types of soaps.If you have a rash in the palm of your hand that does not go away or is accompanied by a persistent burning sensation, see your doctor immediately.

5. Psoriasis

This skin condition is a condition that can cause inflammation in various parts of the body. Psoriasis is inherited and can also be caused by trauma to the epidermis, other skin conditions, or infection.

In addition to psoriatic inflammation on the palms, it can also occur:

  • redness;
  • dryness and flaking of the skin;
  • 90,025 plaques or thickening of the epidermis in the affected areas;

  • painful cracks.

6. Enteroviral vesicular stomatitis

Enteroviral vesicular stomatitis is a highly contagious condition that often occurs in children. It is a viral infection that can cause sores and rashes in the mouth, hands and feet.

Other symptoms of this infection include:

  • fever;
  • sore throat;
  • 90,025 blisters on the tongue;

    90,025 red rash on palms or soles;

  • decreased appetite.

This condition is likely to resolve within a few days with few signs of symptoms. If your symptoms get worse or don’t get better, make an appointment with your doctor.

7. Dyshidrotic eczema

A specific type of eczema that causes small, itchy blisters. If you are diagnosed with dyshidrotic eczema, you may develop blisters on your toes and feet. They are usually painful and clumpy.

This disease most often occurs in women, less often in men.

Blisters will dry and exfoliate within three weeks. To date, there is no cure for this disease, but your doctor can advise you on symptomatic treatment.

8. Impetigo

Another common skin infection in children is impetigo. This condition causes blisters on the face, neck, and arms.

Children are more likely to develop this infection if they already have other skin conditions such as eczema or contact dermatitis caused by plant chemicals.

Impetigo is contagious, spreads from person to person or through contact with things touched by an infected person. Impetigo is also itchy and can spread to other parts of the body.

Do you need treatment

Treatment of a rash on the palms depends on the underlying cause of the symptom. Some rashes can go away on their own and do not require treatment. In other cases, therapy can be simple, but only a doctor can establish the cause of the disease and find remedies for its elimination.

If you have an allergic reaction, you will be prescribed appropriate allergy medication after examination. When the rash is due to atopic dermatitis, eczema, or psoriasis, your doctor may prescribe a topical cream. Such a cream should be applied 30 minutes before going out into the cold, as well as at night and in all other cases when the dryness of the epidermis is clearly pronounced.

For eczema and psoriasis, avoid potential triggers and keep your hands moist to prevent dry skin.

For bacterial or viral infections, your doctor may prescribe a topical or oral antibiotic. If your symptoms do not improve or worsen after treatment, see your doctor again immediately.

Forecast

A rash on the palms is often a minor symptom that can be healed within a few days. However, some cases of this rash could be a sign of a more serious skin condition or infection.

If you start to feel additional symptoms with a rash on your palms, or if the condition of the rash worsens, see your doctor.He will diagnose your disease and select the right treatment.

90,000 Rash in children. We analyze the reasons.

In the life of every parent, sooner or later there comes a moment when, all of a sudden, some acne is found on the body of a beloved child. It’s a rash. A rash is any change in the skin. It occurs in many diseases and conditions, some of them are very dangerous.

Let’s try to figure out what kind of rash, in what cases it appears, what is it accompanied by and how mom and dad should behave so that it goes away faster.

Let’s start with the simplest – insect bites. Primarily mosquitoes. As a rule, this rash is surprising in early spring and late autumn, when mosquitoes are not yet remembered or are already forgotten. In modern winter conditions, mosquitoes can live indoors (for example, in a basement) almost all year round. Of all family members, small children are the most “tasty” for mosquitoes.

Parents notice changes in the skin in the morning, after the child wakes up. Mosquito bites are characterized by the appearance of pink or reddish spots mainly on open areas of the body: hands, forearms, feet, legs, etc.That is, those parts of the body that are not covered by pajamas, and there must be elements on the face, or, sometimes, on one half of it (in the event that the child slept on his side). Most often, this rash is accompanied by itching, but not very severe. The general condition of the child does not suffer. He behaves as usual – he plays, runs, throws things around, watches cartoons and eats with appetite. If the child is not allergic to mosquito bites, then they do not require special treatment. It is enough to turn on the fumigator in the children’s room (now there are special ones, for children), and the problem will be solved by itself.In the case of a severe allergic reaction, accompanied by severe swelling, redness, severe itching, it is necessary to give the child an anti-allergic agent (for example, suprastin). Bites can be treated with drugs such as “Psilobalm” or “Fenistil-gel”, which relieve swelling and irritation.

The next, fairly common situation in which a rash occurs is an allergic reaction. This is usually a food allergy. There are children who are allergic from early childhood.Parents of such children know exactly what food can be given to their child and what not. And they know very well how to take care of the skin in this situation. Now I would like to dwell in more detail on the problem of the sudden development of allergies in a previously healthy child. This situation can develop when eating previously unfamiliar products, exotic fruits, vegetables, seafood. Or in the event that the usual dishes are prepared in a special way, using a large amount of spices and aromatic additives.Or if your child, having lost control, ate a packet of chips, ate tangerines, chocolates and washed it all down with a carbonated drink.

The allergic reaction manifests itself rather quickly. On the skin of the whole body or in certain areas (cheeks, buttocks, behind the ears), red spots appear, irregular in shape, prone to merging and accompanied by severe itching. The general condition of the child may change: he may be lethargic or, conversely, too excited. Sometimes there is vomiting or loose stools.But more often the child feels good, but itches very much. How can you help your baby in this situation? First of all, it is necessary to exclude from his diet foods that cause an allergic reaction, even if they are very tasty and he loves them very much. Then you need to give the child sorbents – drugs that will remove the allergen from the child’s body. These include activated carbon, smectite, zosterin-ultra, filterum. It is mandatory to take antiallergic drugs (all the same suprastin or other drugs from this group).Fenistil-gel and moisturizing cream are applied to the skin. It would be very nice to see a pediatrician or dermatologist.

An allergic reaction can also occur when the skin comes into contact with some substances, for example, washing powder, fabric softener, etc. In this case, the rash appears only in those areas that have been in direct contact with the allergen. Parental tactics in this case are similar to those for food allergies. Additionally, the substance that caused the reaction should be removed from the skin – rinse off under running water.

Now it is necessary to dwell on a large group of infectious diseases accompanied by a rash.

Chickenpox (chickenpox).

The appearance of a rash, as a rule, is preceded by mild malaise, symptoms of mild acute respiratory infections may be observed. Then a rash appears. At first, there is little of it – a few red spots. Every day more and more new spots appear, and the old ones turn first into a papule – a “tubercle” slightly protruding above the skin, then into a bubble with transparent contents, and, finally, the bubble dries up and a crust forms, which after a while disappears.From the moment the first speck appears until the last crust falls off, it takes about 10-15 days, during which the sick child is contagious. The chickenpox rash is common throughout the body, including the scalp and mucous membranes (mouth, eyes, genitals). The appearance of a rash with chickenpox is accompanied by itching, sometimes quite severe. Therefore, you can use the already known suprastin, fenistil gel or psilobalm.

Rubella.

In rubella, the rash appears almost simultaneously throughout the body, but is more pronounced on the face, chest and back.It looks like small pale pink spots, almost the same size. The rash is profuse. Disappears without a trace within 4 days. A characteristic feature of rubella is enlargement of the occipital lymph nodes. All this is accompanied by mild symptoms of acute respiratory infections. There is usually no specific treatment for rubella. But all children under 1 year of age are advised to be vaccinated against rubella.

Scarlet fever.

The disease begins acutely with high fever, sore throat when swallowing, tonsillitis.At the beginning of the disease, the tongue is thickly coated with a white bloom, then it becomes bright red, shiny. The rash appears a few hours after the onset of the disease on the trunk, limbs, with thickening in the natural folds of the skin (armpits, groin area). The rash is pink, small-punctate. At the same time, the area around the mouth remains pale. After the disappearance of the rash at the end of the first – at the beginning of the second week of the disease, peeling appears on the palms and feet. The disease is quite serious, because leaves behind complications in the form of heart and kidney damage.Requires the mandatory prescription of antibiotics and a period of dispensary observation with mandatory monitoring of blood and urine tests.

Measles.

A rash with measles appears on the 4th-5th day of illness against the background of strongly pronounced signs of acute respiratory infections (cough, runny nose, conjunctivitis, high fever) and rash within 3-4 days. The first elements of the rash appear on the face, upper chest. On the second day, they spread to the body, and on the third, to the upper and lower extremities.Looks like small red spots that tend to merge. It is now rare due to the immunization of children as young as 1 year old.

“Sudden exanthema”, “roseola” or “sixth disease”.

It manifests itself in high, up to 39C, temperature for 4-5 days with relatively good health. Then the temperature returns to normal, and a soft pink rash appears all over the body. After the rash appears, the child is not contagious. Very often, this rash is mistaken for an allergic reaction to antipyretic drugs.

Meningococcal disease and meningococcal sepsis are deadly diseases.

It is manifested by a very high temperature, a difficult general condition of the child, which worsens every hour, vomiting, impaired consciousness. Against the background of a high temperature, the child develops a rash (there may be only a few elements), which does not disappear with pressure. If you see such a picture in a child, you should immediately call an ambulance.

In addition to these diseases, a rash on the body occurs with herpes infection – in the form of vesicles, with infectious mononucleosis – with the appointment of antibiotics from the amoxicillin group, with pseudotuberculosis and yersiniosis – like “socks” and “gloves” and many others.

As a rule, a rash with various infections is quite typical and additional laboratory examination is not required to make a diagnosis.

In almost all infectious diseases, in addition to the rash, there is a high (or not very) temperature, general malaise, loss of appetite, chills. You may have a headache, or your throat, or your stomach. There is a runny nose, or a cough, or diarrhea.

In addition to infections, the rash occurs in diseases of the blood or blood vessels.In these cases, the appearance of a rash is provoked by injuries, sometimes very minor. The rash looks like large or small hemorrhages (bruises) and requires additional examination to make an accurate diagnosis.

In conclusion, I would like to once again draw the attention of parents to the fact that we do not need to try to understand what kind of rashes the child has. Call a doctor. And the most important thing is not to paint on this rash with fucorcin, iodine or brilliant green. Once you have satisfied your drawing needs, no doctor will ever guess what was really there.

Warts-like rash on the hands – Question to the dermatologist

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90,000 Skin symptom found in coronavirus

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Urticaria can be one of the complications of the disease

A group of French doctors confirmed that during the observation of patients infected with coronavirus, a number of them showed a new symptom – a skin rash that looks like hives.Since most often such patients do not have severe manifestations of coronavirus infection, there are grounds to assume that they can transmit the virus, including through the skin. To what extent such assumptions are justified, we asked the experts.

Doctors report that in different patients, coronavirus infection manifests itself in completely different symptoms: for some, it passes with a fever, for others without; some have a runny nose, others do not; cough is also not the main symptom.Now, according to BFMTV, French experts from the National Syndicate of Dermatologists-Venereologists have identified another symptom that could indicate infection: a rash that resembles hives.

Some patients suffer not only from reddening of the skin, but also from itching. In some cases, redness can be painful. But it has not yet been possible to establish the exact reasons for the effect of the virus on the skin. Scientists propose to deal with such cases urgently, because theoretically, patients with similar symptoms may have an increased degree of transmission of the virus, despite the fact that they do not always have respiratory manifestations of the disease.

As “MK” told the head of the Department of Infectious Diseases SBEE HPE “First MGMU named after I. M. Sechenov “Ministry of Health of the Russian Federation Elena Volchkova, in the serious scientific literature she has not seen data on patients infected with COVID-19 with similar symptoms:” Even the Chinese, who have gained vast experience in monitoring such patients, have never reported, and this is very strange. Therefore, we need to collect more data to get confirmation of this fact.

It is possible that the rash in these patients may be completely unrelated to the coronavirus infection.It is possible that this is generally an allergic reaction, including the administration of drugs. We do not know the age of these patients, their history, or information about the presence of an allergic component. Of course, there are infections in the world in which rashes are an important symptom. It is difficult only by the presence of a rash to judge what kind of disease it is. “

Meanwhile, urticaria remains one of the most common types of allergic reactions in the world. According to expert estimates, every fifth inhabitant of our planet has encountered it at least once in his life.It manifests itself as itchy skin and rashes similar to insect bites or burns and from nettles, in response to exposure to a substance (internally or externally).

Itching increases with stress, scratching and alcohol consumption. The reason for the appearance of such rashes can be food (any, but most often it is highly allergenic oranges, strawberries, chocolate, peanuts, chicken eggs, etc.), plants, dust, animal hair.

Many medicines, even phyto (first of all, penicillin antibiotics), insect bites, non-steroidal anti-inflammatory drugs (the same ibuprofen or paracetamol, which usually knock down the temperature) and even weather factors (sun, heat, cold, etc.)) In addition, urticaria can accompany any viral disease (each ARVI can give a rash in the form of a reaction of the body to a new virus). Therefore, so far there are more questions than answers with the new symptom of COVID-19.

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90,000 Rash on a child’s arm – Dermatology and cosmetology – 11.09.2012

anonymous (Female, 32 years old)

Rash on the arm of a child

Hello, the child has a rash on the bend of the arm for three months already, it disappears, then appears again, sometimes more, sometimes less. We went to a dermatologist, prescribed Zyrtec, polysorb, cream topically ….

anonymously (Woman, 8 years old)

Rash on the hands of a child

Hello. In mid-January, a child (a girl, 8 years old) at school had both hands scratched, bloody wounds appeared, and the hands were treated with hydrogen peroxide.After that, the child’s hands are constantly itching, he scratches …

anonymous (Woman, 31 years old)

Rash on the child’s arms

Hello. Before the new year, a child (4d) developed a rash on his hands, closer to the wrist. The dermatologist said allergic, drank the pills, sat on a diet, everything went away, but then again, she assured me …

anonymous (Woman, 34 years old)

Rash on the child’s arm

Rash on the back of the child’s palms. ” The child periodically developed a rash on the bend of the elbow of one arm, it was not possible to trace the cause, she is not allergic, they experimented with food (and…

ViRo furniture workshop (Woman, 11 years old)

Rash on the arm of a child, daughter of 11 years old

Hello, my daughter has a strange rash on her arms, I’m attaching a photo, it looks like lichen, I can’t understand the variety. Tell me what it is and how to treat it? Perhaps stroking stray animals. There is a cat at home.

anonymous (Male, 11 years old)

Rash on the hands of a child

Hello! My son is 11 years old, at the beginning of May “pimples” appeared on the hands. Now they are becoming more and more and they itch.The child is allergic to field grasses, we take oraleir. Maybe …

anonymous (Woman, 31 years old)

Rash on the body of a child 8 years old

Hello. My daughter is 8 years old for the second day now with a rash on her arms, legs, and bottom. No itching. I attach a photo. 4 A day ago, the temperature rose to 37.8. We began to take Kagocel. We drank for 4 days, the temperature was 1 day. There were no more signs of the disease …

90,000 causes, diagnosis and treatment – Rambler / female

Photo: US Dermatology Partners Wrist Rash: Causes, Diagnosis and Treatment A wrist rash can result from infection, genetic factors, or contact with a substance that causes irritation or an allergic reaction.

Causes and Symptoms

Depending on the cause, a rash on the wrist can have a wide variety of symptoms. It is often possible to determine the cause of a rash based on its specific symptoms.

The rash usually has the following characteristics:

with blistering;

Common causes of wrist rash include:

Allergic reaction

When external substances or materials cause an allergic skin reaction, it is called allergic contact dermatitis.An allergic reaction causes skin irritation and reddish-pink blisters that usually appear within 2 to 3 days after skin contact with the allergen.

Nickel is one of the most common causes of allergic contact dermatitis.

Other common triggers of contact dermatitis include:

detergents and soaps;

Poison Ivy or Poison Oak;

lanolin, which is found in many cosmetics;

formaldehyde, which is found in many fabrics, especially waterproof clothing;

latex, from which balloons and rubber gloves are made.

Eczema, also called atopic dermatitis, irritates the skin. Eczema causes specific blemishes on dry, red, chapped skin that can sometimes swell or bleed. This skin condition can affect any part of the body, but is more common in skin folds. Eczema often causes severe rashes on the wrists and ankles, especially in children, and conventional treatments are ineffective in these areas.

Drug reaction

A person with a drug allergy may notice an itchy, pink, or red rash on the body after taking drugs.Rash after taking medications can usually only appear on one part of the body, arm or wrist. Allergic reactions can be caused by penicillin and other antibiotics, sulfate drugs.

Lichen Red Flat

Lichen Red Flat (Lichen Planus) is a common non-contagious autoimmune disease. This condition primarily affects the skin, but it can also spread to the nails, scalp, and oral mucosa. Lichen can develop anywhere on the body, including the wrists, lower back, and feet.The disease results in small bumps on the skin, usually reddish purple, shiny and hard to the touch. There may be small white lines on the bumps.

Scabies is a contagious disease that occurs when Sarcoptes scabiei mites invade the skin, causing a very itchy rash. The scabies rash consists of small pinkish bumps. The rash is more common in folds of skin such as between the fingers, around the wrists, and in the elbows and knees.

After infection with scabies, symptoms may appear 2-6 weeks after infection.Symptoms appear much faster if the person has had scabies.

Viral or bacterial infection

Many infections can cause a rash on the wrist. In some cases, the rash will go away when the infection clears up. However, if the fever is accompanied by a rash, there is a possibility that the infection could be serious and the person should see a doctor.

Rocky Mountain spotted fever

Spotted fever, or Brazilian typhus, is an infectious disease that occurs from tick bites.This condition manifests itself as a patchy or punctate rash anywhere on the body, including the hands and wrists. The rash may appear 2 to 4 days after a person develops a fever. Other symptoms include headache, nausea, muscle pain, and loss of appetite. Left untreated, Rocky Mountain spotted fever can cause serious health complications and quickly develop into a life-threatening illness.

Your doctor will do a detailed physical examination to determine the cause of the rash on your wrist.A doctor may use skin patch testing and a skin biopsy to look for allergies or other skin conditions that may be causing the rash, and will run a blood test to check for allergies or infectious diseases.

Although symptoms can be very similar for different types of rash, treatment will depend on what is causing the particular flare-up. For example, if a person is allergic to nickel and develops a rash on their wrist after wearing a new bracelet for a few days, it is best to stop wearing that bracelet.Likewise, people who develop a rash after taking a new drug may need to stop taking that drug, but only under the direction of a doctor. When the rash is part of an allergic reaction, people can take antihistamines to reduce redness, itching, and pain. If the rash spreads to other parts of the body or if distressing symptoms such as fever develop, you should see your doctor for a more complete evaluation. The doctor may prescribe:

antihistamines;

Corticosteroid ointments and skin lotions;

antibiotic ointment;

corticosteroids;

phototherapy with ultraviolet light;

biological or other therapy with the use of immunosuppressants.

The antibiotic doxycycline is recommended for the treatment of spotted fever and patients should start taking it as soon as possible.

Allergy to sweets: allergy to sugar


If you eat a chocolate bar once, no significant changes will occur. But if you eat in large portions, you risk getting an incredibly painful bonus in the form of a rash, for example. Also, it should be borne in mind that there is a predisposition to allergies to certain foods.


This means that excessive consumption of these products will cause illness, but using them in small portions will rarely harm your health.

Types of allergies to sweets

In general, there are two types of allergy to sweets:

  • Allergy to components of a sweet product.

If the product contains colorants, flavor enhancers, flavors and other food additives; contains a product to which you are already allergic (hazelnuts, almonds, cocoa).In this case, everything is decided by changing the product and switching to other products that do not contain allergens.

  • Sugar allergy.

Applies to all sweets. An exception is sugar-free sweets (for diabetics, for example).

Symptoms of allergy to sweets

So, the symptoms of a sweet allergy, by which this disease can be identified:

  1. Nausea, vomiting, flatulence, eating disorders are characteristic signs of all food allergies, including allergy to sweets.
  2. Skin rashes, itching, burning, redness – these symptoms are also a characteristic indicator by which you can understand what we are facing.

If you see similar symptoms in yourself or in a child, feel free to send your feet to the hospital for passing tests, confirming tests, prescribing treatment. All this is very important, because allergies will not go away on their own, but will only turn into chronic forms and aggravate your health condition.

Methods of dealing with this allergy

How can you avoid such a nuisance as an allergy to sweets? Pretty simple.

  1. Control the amount of treats you eat. This may seem daunting to you, but the less chocolate, cakes, and other sweets you eat, the less likely you are to develop allergies.
  2. Try to vary your menu in moderation. If you eat 20 grams of chocolate, one cake, three waffles and 50 grams of halva, you have less chance of getting yourself allergic than if you eat two whole chocolates.
  3. Healthy lifestyle.Yes, it will not relieve you of allergies completely. But it will help to reduce the strength of symptoms and overall strengthening of the body. Therefore, quit bad habits, do exercises, take time for walks and hardening. And your well-being will improve significantly.

Allergy to sweets in children

A separate topic is the allergy to sweets in children. Even determining whether a child is allergic is a big problem. Are these spots just irritation or allergies? But what is this rash from? And after all, it is very difficult for them to explain how it is, literally yesterday it was possible, but today it is no longer possible.At all. Not a grain. The child will be capricious, cry. It may even throw tantrums – but your duty, as a parent, is not only not to give him sweets, but also to explain why this is so. If the allergy attack was rather painful and unpleasant, then it will be easier to explain. And if it was unpleasant, but almost imperceptible redness, you will have to diligently and calmly explain what has changed. You should show the same diligence and calmness in relation to your relatives, who may well want to “pamper” the baby.You will be surprised how many situations there were when a grandmother comes to the doctor with a rash-covered grandson. The child is allergic to sweets and the grandmother knows about it. But she decided to give a little: “He asks the same.” All attempts to give your child something that he should not use should be stopped. It’s like giving him a cigarette or drinking an alcoholic beverage. This is very harmful and will not be useful, even if just a little. Unfortunately, children do not always understand that issues related to health are very important and therefore you should warn educators and teachers in case something like this is given for lunch in the cafeteria.And also if something happens to your child so that they know. How to react and what to expect.

Symptoms of allergy to sweets in children

Symptoms of a sweet allergy in a child are the same as in adults. And recommendations for avoiding it too. If a child walks a lot, eats well and variedly, but without overeating, does exercise, and even better, does some kind of sport that develops the body, then his body is less likely to be susceptible to allergies, in particular, and other diseases in general.And do not forget – the child’s allergy is your fault too. Yes, allergies could arise due to hereditary predisposition or poor environmental conditions. Or perhaps you overprotect the child, overfeed him or his diet is not varied and complete enough. And it is quite possible that by improperly eating during pregnancy or feeding, you, without noticing it, yourself provoked this allergy. Therefore, for the health of your child, you must also take care of yourself, your diet and your general health.Healthy parents usually have and raise healthy children.

Diagnostics and treatment

For the purpose of diagnosis, the child will need to pass immunological blood tests, and older children will also need skin tests (when a specialist injects a drug prepared on the basis of different types of allergens into a scratch on the skin, and after a while studies the response). If the allergen has been identified, it will be important to protect the child from contact with it, for example, by excluding it from the diet, even if the painful reaction is not caused by food.The fact is that the development of allergies is associated not with one, but with many types of irritants. Only a doctor can prescribe a course of treatment with drugs for a child, and the choice of anti-allergic drugs is now great. There is no need to worry if the medicine is prescribed for a long time: modern drugs have a minimum number of side effects.

At the slightest sign of allergy, you need to see an allergist.