Rash (cont.)
Scaly patches of skin produced by fungal or bacterial infection
When infections appear as rashes, the most common culprits are funguses or
bacterial infections.
Fungal infections: Fungal infections are fairly common but don't
appear nearly as often as
rashes in the eczema category. Perhaps the most common diagnostic mistake made
by both patients and non-dermatology physicians is to call scaly rashes "a
fungus." For instance, someone with several scaly spots on the arms, legs, or
torso is much more likely to have a form of eczema or dermatitis than actual
ringworm (the layman's term for fungus). Likewise, yeasts are botanically related to fungi and can cause skin rashes. These tend to affect folds of skin (like the skin under the breasts or the groin). They look fiery red and have pustules around the edges. As is the case with ringworm, many rashes that are no more than eczema or irritation get labeled "yeast infections."
Fungus and yeast infections have little to do with hygiene—clean people get them
too. Despite their reputation, fungal rashes are not commonly caught from dogs
or other animals, nor are they easily transmitted in gyms, showers, pools, or
locker rooms. In most cases, they are not highly contagious between people
either.
Treatment is usually straightforward. Many effective antifungal creams can be
bought at the drugstore without a prescription, including 1% clotrimazole (Lotrimin, Mycelex) and 1% terbinafine (Lamisil).
Bacterial infections: The most common bacterial infection of the skin is
impetigo. Impetigo is caused by staph or strep germs and is much more common in children than adults. Again, poor hygiene plays little or no role. Nonprescription antibacterial creams like
bacitracin or Neosporin are not very effective. Oral antibiotics or prescription-strength creams like Bactroban are usually needed.
Red, itchy bumps or patches all over the place
Outbreaks of this sort are usually either viral or allergic.
Viral rash: While viral
infections of the skin itself, like herpes or shingles (a cousin of chickenpox),
are mostly localized to one part of the body, viral rashes are more often
symmetrical and everywhere. Patients with such rashes may or may not have other
viral symptoms like coughing, sneezing, or an stomach upset (nausea). Viral rashes usually
last a few days to a week and go way on their own. Treatment is directed at relief of itch, if there is any.
Allergic drug rash: Most allergic drug rashes start within two weeks of taking a new medication,
especially if the person has taken the drug before. It is very unlikely for
medicine that has been prescribed for months or years to cause an allergic reaction. Because
there is usually no specific test to prove whether a rash is allergic, doctors
may recommend stopping a suspected drug to see what happens. If the rash doesn't
disappear within five days of not taking the medication, allergy is unlikely.
Although foods, soaps, and detergents are often blamed for widespread rashes,
they are rarely the culprit.
Other rashes
Hives (urticaria) are itchy, red welts that come and go on various parts of
the body. Most hives are not allergic, run their course, and disappear as
mysteriously as they came.
Next: What is the treatment for a rash? »
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