The dermatologist understands the term erythema to mean a reddening of the skin caused by increased blood flow to the affected area of the body. The causes are varied and must be clearly identified in order to initiate adequate treatment. The prognosis depends on the underlying disease, but usually the erythema fades by itself after a short time.
What is erythema?
Erythema is a reaction of the skin and body to certain bodily processes or is caused by external influences. The word erythema is derived from the ancient Greek term “erýthema,” which means “redness” or “inflammation.” It thus describes the only symptom of erythema, the redness of the skin. This can occur in different color intensity, size, extension and strength. Erythema belongs to the so-called primary florescences. These are skin redness and skin changes that result from a pathological process that takes place directly in the skin. They are not affected by other diseases. For this reason, primary florescences have a high diagnostic value. Other important skin changes in this group are macules, a skin redness caused by pigmentary abnormalities, papules, and cysts.
Causes
The causes of erythema are varied. Therefore, it is not possible to make general statements. However, in principle, it can be said that erythema on the one hand can be a normal, possible in all people, when it occurs as blush. Erythema, which is called erythema pudoris by dermatologists, is colloquially referred to, for example, by the saying “to put a blush on someone’s face” and is harmless. On the other hand, erythema is an important symptom of many skin diseases. Important examples are disk rose, Stevens-Johnson syndrome, and “scalded skin syndrome.” Disc rose primarily affects adolescents and appears on the extremities and face. The disc-like, fingernail-sized erythema often occurs along with joint pain, fatigue, and low-grade fever and heals spontaneously after some time. Those affected by Stevens-Johnson syndrome also suffer from a severely disturbed general condition. Symptoms of this disease include erythema, high fever, herpes-like vesicles in the mouth and genital area, and conjunctivitis. Causes of Steven Johnson syndrome are often insufficiently healed infections or allergic reactions. Scalded skin syndrome, also known as Lyell syndrome, is life-threatening because the entire epidermis detaches from the body in affected individuals. It then dies and the protective function of the skin is massively disturbed. The cause of this disease is severe allergies or side effects of certain medications.
Symptoms, complaints and signs
Erythema can cause various symptoms and complaints. The condition is primarily manifested by a noticeable reddening of the skin, which can appear on different parts of the body. Erythema usually occurs in areas of the body with a high blood supply, for example on the chest, arms or intimate areas. Erythema can be recognized by the fact that it changes color when pressure is applied. Usually, it does not cause pain itself. However, the causative condition may cause pain and other symptoms in the later stages. Depending on the cause of the erythema, serious symptoms may occur. If the symptoms are based on a skin hemorrhage, itching and pain usually occur as well. If the erythema occurs as a precursor of eczema, further skin changes occur in the course, up to bleeding and skin itching. In the absence of treatment, erythema increases in size and may spread over the entire arm, chest, or genital region. Sensory disturbances are conceivable with larger erythemas. In addition, those affected often feel ill, which increases with the enlargement of the reddening of the skin. If erythema is treated early, there are usually no further symptoms or discomfort.
Diagnosis
The affected person usually notices the skin redness on his or her own and goes to a dermatologist. When making an appointment, it is important to describe the observed symptom as precisely as possible so that an urgency classification can be made. Otherwise, the patient may wait a very long time for an appointment. The dermatologist should be able to recognize at first glance whether there is erythema, skin bleeding or the preliminary stage of eczema.It is helpful in the diagnosis to apply pressure to the affected area, because if it can be discolored with this, there is clearly erythema. In most cases, the dermatologist will refer the patient to a general practitioner to initiate diagnosis and treatment of the underlying condition. Nevertheless, a dermatologist should be consulted first to rule out other conditions.
Complications
In the case of erythema, the complications associated with the redness of the skin depend on the cause. If the erythema is caused by an infection, dangerous symptoms may develop without treatment. Thus, secondary infections of the affected areas of the skin but also of other organs may develop, which can be life-threatening. Treatment with antibiotics is indicated if a bacterial infection is the cause of the erythema, and erythema caused by fungal infections should also be treated with medication. However, treatment with medications can also lead to complications, as allergic reactions and intolerances are possible. These can also manifest themselves in skin symptoms, and in extreme cases, life-threatening allergic shock with circulatory failure can occur. If an allergic reaction is the reason for the appearance of erythema, in the case of a contact allergy it is usually sufficient to avoid the triggering substance. The redness of the skin then usually disappears on its own, without the need for further treatment. However, in the context of allergic reactions, inflammatory changes of the erythema can also occur, which spread to deeper skin layers. Secondary infections are another possible complication here. Likewise, even with adequate treatment, scarring may occur in the affected areas. As a complication of inflammatory skin processes, fever and a reduced general condition are also possible.
When should you see a doctor?
Erythema should be cleared by a physician as soon as complications develop. Redness on the skin, fever or joint pain require medical clarification in any case. The same applies to bleeding, itching and other symptoms that impair well-being. Especially if the symptoms have not subsided after two to three days at the latest, an appointment should be made with a general practitioner. People who perceive the erythema as a cosmetic blemish are also best off talking to a therapist. Large lesions in particular should be discussed with a professional before psychological upset sets in. If inferiority complexes or depression are already noticeable, the following applies: seek psychological advice immediately. The sooner mental health problems are treated, the less likely they are to have long-term consequences. That being said, individuals with a pre-existing condition such as Stevens-Johnson syndrome or a skin condition should see a doctor with erythema. Generally, erythema indicates a serious condition and therefore needs to be investigated and treated if necessary. In case of severe complications, it is best to call emergency medical services.
Treatment and therapy
Treatment of erythema depends on the underlying condition diagnosed. While some causes, such as disk rose, cannot be treated, other causes can still be treated if diagnosed in time. The erythema itself cannot be treated. A special form of erythema is erythroderma: this is present when more than 90% of the body is affected. Erythroderma means “red skin” in ancient Greek. The skin is severely inflamed and the vessels are dilated. There is a loss of fluid, protein and salt, which can lead to life-threatening secondary infections. Patients suffer from severe heat loss from the body due to the vasodilatation and thus excessive sensitivity to cold. A first indication of erythroderma is therefore the clothing style of affected persons, which is always perceived by others as too warm. Like erythema, erythroderma is not a disease in its own right. It is a symptom and thus an important indication of other diseases and phenomena, for example, of old age, drug intolerance or psoriasis.
Outlook and prognosis
Depending on the underlying cause of the erythema, the skin redness may develop differently. If a harmless inflammation is causative, it usually subsides after a few hours to days.In serious skin diseases, on the other hand, erythema may persist for weeks and months. Patients of a chronic skin disease suffer permanently from skin changes. Nevertheless, the prognosis is usually good – erythema is usually unproblematic and does not cause any further complaints apart from itching and pain. In individual cases, an erythema can develop into eczema, which can increase in size and cause accompanying symptoms such as fever. In the worst case, eczema can lead to inflammation and thus to sepsis. Spread to the internal organs is also conceivable and associated with a rather poor general prognosis. However, with early treatment, the prospect of a rapid recovery is good. The dermatologist can prescribe suitable medications and care products with which the skin changes can be reliably treated. In principle, erythema therefore has a good prognosis. If the skin changes are clarified and treated early, they usually subside again or at least do not progress further.
Aftercare
As a rule, there are hardly any measures and options for aftercare available to the person affected by this disease. The disease must be treated thereby primarily by a physician, so that it does not come to further complications and complaints. The further course of the disease also depends very much on the exact underlying disease that is responsible for the erythema, so that here no general prognosis can be made about the further course. However, early detection and subsequent treatment always have a positive effect on the further course of the disease. In most cases, those affected by this disease are dependent on taking medication. These should be taken regularly, paying particular attention to the doctor’s instructions. In case of questions or uncertainties, a doctor should always be contacted first. In many cases, those affected must also adapt their clothing style, as the sensation of warmth or cold can also be disturbed by the disease. A doctor can also be of assistance here. In everyday life, many sufferers rely on the help of family and friends, although contact with other sufferers can also be useful.
What you can do yourself
With erythema should in any case go to the family doctor or dermatologist. What measures the affected person can take himself depends on what cause the medical professional determines and how pronounced the skin change is. If a drug intolerance is the cause, it is sufficient to change the medication. The actual redness should subsequently recede on its own. Regular skin care with gentle products supports the breakdown of the damaged tissue. Various natural remedies also reduce the redness of the skin, but should only be used in consultation with the doctor in charge. The same applies to alternative healing methods such as heat or cold treatments or ultrasound therapy. If the erythema is due to an unhealthy lifestyle, appropriate changes in daily habits are recommended. If external influences such as excessive exposure to sunlight or environmental toxins are the cause, prudent behavior in everyday life can help, as can preventive measures. In general, erythema can be reduced by wearing suitable clothing (e.g. cotton or linen) and avoiding irritating perfumes and skin care products. If the skin changes persist despite all this, a doctor must provide treatment. Patients with skin diseases such as atopic dermatitis should generally refrain from self-measures.
