What health care professionals diagnose and treat rashes?
Dermatologists, pediatricians, infectious diseases specialists, and many internists are capable of identifying most rashes.
How do health care professionals diagnose common skin rashes?
The term rash has no precise meaning but often is used to refer to a wide variety of red skin eruptions. A rash is any inflammatory condition of the skin. Dermatologists have developed various terms to describe skin rashes. The first requirement is to identify a primary, most frequent feature. The configuration of the rash is then described using adjectives such as "circular," "ring-shaped," "linear," and "snake-like." Other characteristics of the rash that are noted include density, color, size, consistency, tenderness, shape, and even temperature. Finally, the distribution of the rash on the body can be very useful in diagnosis since many skin diseases have a predilection to appear in certain body areas. Although certain findings may be a very dramatic component of the skin disorder, they may be of limited value in producing an accurate diagnosis. These include findings such as ulcers, scaling, and scabbing. Using this framework, it is often possible to develop a list, called a differential diagnosis, of the possible diseases to be considered. An accurate diagnosis of a skin rash often requires a doctor or other health care professional. On the basis of the differential diagnosis, specific laboratory tests and procedures can be conducted to identify the cause of a particular rash.
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Rashes produced by fungal infections
Fungal infections are fairly common. 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 (blisters) around the edges.
Fungus and yeast infections have little to do with hygiene -- clean people get them, as well. Fungal rashes are not commonly acquired from dogs or other animals. They seem to be most easily acquired in gyms, showers, pools, or locker rooms, or from other family members. Many effective antifungal creams can be bought at the drugstore without a prescription, including 1% clotrimazole (Lotrimin, Mycelex) and 1% terbinafine (Lamisil). With extensive infection, or when toenails are involved, a prescription drug may be useful, such as oral terbinafine.
If a fungus has been repeatedly treated without success, it is worthwhile considering the possibility that it was never really a fungus to start with but rather a form of eczema. Eczema is treated entirely differently. A fungal infection can be independently confirmed by performing a variety of simple tests.
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Rash due to parasites
One of the most common rashes from a parasite infection is scabies. Scabies is produced by a small mite (related to a spider). This mite is usually contracted by prolonged contact with another infected individual. The mite lives in the superficial layers of human skin. It does not produce symptoms until the host becomes allergic to it, which occurs about three weeks after the initial infection. It can resemble eczema. Bedbugs cause a series of eruptions where they pierce the skin.
Rashes that characteristically occur as part of certain viral infections are called exanthems. Many rashes from viruses are more often symmetrical and affect the skin surface all over the body, including roseola and measles. Sometimes certain viral rashes are localized to the cheeks, such as parvovirus infections (fifth disease). Other viral infections, including herpes or shingles, are mostly localized to one part of the body. Patients with such rashes may or may not have other symptoms like coughing, sneezing, localized burning, or stomach upset (nausea). Viral rashes usually last a few days to two weeks and resolve on their own.
Quick GuideRosacea, Acne, Shingles: Common Adult Skin Diseases
What is the treatment for a rash?
Most rashes are not dangerous. Many rashes last a while and get better on their own. It is therefore not unreasonable to treat symptoms like itchy and/or dry skin for a few days to see whether the condition gets milder and goes away.
Nonprescription (over-the-counter) remedies include the following:
- Anti-itch creams containing 1% hydrocortisone cream can be effective
- Oral antihistamines like diphenhydramine and hydroxyzine can be helpful in controlling the itching.
- Moisturizing lotions
- Fungal infections are best treated with topical antifungal medications that contain clotrimazole (Lotrimin), miconazole (Micatin), or terbinafine (Lamisil).
If these measures do not help, or if the rash persists or becomes more widespread, a consultation with a general physician or dermatologist is advisable.
There are many, many other types of rashes that we have not covered in this article. So, it is especially important, if you have any questions about the cause or medical treatment of a rash, to contact your doctor. This article, as the title indicates, is just an introduction to common skin rashes.
A word on smallpox vaccination in patients with rashes
People with atopic dermatitis or eczema should not be vaccinated against smallpox, whether or not the condition is active. Patients with atopic dermatitis are more susceptible to having the virus spread on their skin, which can lead to a serious, even life-threatening condition called eczema vaccinatum. In the case of other rashes, the risk of medical complications is much less. Consult your doctor about the smallpox vaccine.
What is the prognosis for a rash?
The prognosis depends on the cause of the rash. An accurate identification is, therefore, of great importance in predicting its resolution.
Is it possible to prevent rashes?
If the cause of a particular rash is known it can be avoided. For example: a measles vaccination would be of great benefit in preventing the rash of measles, as well more serious consequences of measles infections.
Medically Reviewed on 8/3/2018
Bolognia, Jean L., Joseph L. Jorizzo, and Ronald P. Rapini. Dermatology, 2nd Ed. Spain: Mosby, 2008.
Rawlin, Morton. "Exanthems and Drug Reactions." Australian Family Physician 40.7 July 2011: 486-489.
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