Skin Rash (Exanthema): Causes, Treatment & Help

Skin rashes come in many forms and types. If they occur suddenly, the medical profession speaks of an exanthem. This can have numerous causes, take on different manifestations and occur in different parts of the body. Therapy depends on the cause.

What is a skin rash?

Exanthem is an acute skin rash that can occur on a limited area of the body or spread over the entire body. Exanthem is an acute-onset skin rash that can occur on a limited area of the body or spread over the entire body. The rash may spread slowly over the body or move from one part of the body to another. Most often, the exanthema appears as red patches on the skin, but other manifestations are also possible. Physicians use the term efflorescences to describe the individual skin changes and distinguish between primary and secondary efflorescences. Primary efflorescences are the skin changes that appear first, including spots, nodules, vesicles or wheals. If the rash changes as it progresses, it is referred to as secondary florescences, which include scales, ulcers, plaques, and scars. In addition, depending on the cause, symptoms such as itching, pain, and fever may occur.

Causes

The causes of exanthema are varied and require the distinction of three types of exanthema. The first is infectious exanthema caused by bacteria, fungi, viruses, fungi, or parasites. These include lice, herpes zosteroder simplex, and lichens. The second form is exanthema associated with systemic internal diseases. This includes lupus erythematosus, a rarely occurring chronic inflammatory connective tissue disease. The third form of exanthema occurs in venereal and pediatric diseases or allergies. In allergies, conctact or drug exanthema occurs, which is often associated with other symptoms. Typical childhood diseases are measles, rubella, scarlet fever and chickenpox. Rarely, immune deficiency is the cause in HIV infection.

Diseases with this symptom

  • Systemic lupus erythematosus
  • Cutaneous lupus
  • Rubella
  • Scarlet fever
  • Syphilis
  • Chickenpox
  • HIV infection
  • Psoriasis
  • Neurodermatitis
  • Rosacea
  • Shingles
  • Allergy
  • Drug exanthema in baby and child
  • Measles
  • Seborrheic eczema

Diagnosis and course

In the case of exanthema, the affected person should quickly consult a doctor to ensure the rapid initiation of appropriate therapy. The right place to start is a dermatologist, but also a general practitioner or pediatrician can help. During the detailed anamnesis, the doctor will ask about the time and body site of the first appearance, previous illnesses, medication use and accompanying symptoms such as itching, fever, nausea or signs of a cold. It is also important to ask whether the patient has had contact with ill persons. Often, the localization of the rash provides important clues to the cause. For example, viral exanthema often begins in the head area and spreads from there over the body. A rash on the abdomen, back or chest is an indication of a drug reaction. During the subsequent detailed examination of the rash, the physician uses aids such as a magnifying glass or a spatula. Blood tests, allergy tests and swabs may also be used to confirm the diagnosis.

Complications

Skin rash can cause multiform complications. First, a secondary bacterial infection may occur, in which other areas of the skin are also affected by the rash. Pigmentary abnormalities or hemorrhages often occur, and in chronic rash, scars form and sensory disturbances (paresthesias) occur in the affected areas. Skin rash as a result of cold allergy can lead to circulatory shock in severe cases. Skin rash occurring as a result of shingles is no less problematic: the zoster viruses spread to other areas of the skin and, under certain circumstances, to internal organs and external organs such as ears and eyes. If the visual and auditory organs are affected, there is a risk of blindness and loss of hearing. The complications therefore always depend on the original trigger of the skin rash.An immune deficiency can contribute to the pustules and redness spreading more quickly and the rash intensifying overall. This is accompanied by the development of nodules or blisters, which also deviate visually from the original rash. During the treatment itself, the medications used, in the case of rash usually ointments or similar, can lead to an intensification of the symptoms. If there is an underlying allergy, depending on the type and severity of the allergy, various accompanying symptoms may occur, such as shortness of breath, severe pain, inner turmoil and, in severe cases, organ failure.

When should you go to the doctor?

Skin rash caused by intolerance to a detergent or cream often disappears on its own within a few days – if this is not the case, a doctor should be consulted. If the rash appears very suddenly or its cause is unclear, on the other hand, it is advisable not to wait so long, but to seek advice from a dermatologist as soon as possible. The same applies if children are affected or the rash is accompanied by swelling, pain or severe itching. Accompanying symptoms such as fever, difficulty swallowing or shortness of breath should also be taken as an opportunity to have the skin examined by a doctor immediately. Often, skin changes also occur in episodes or the rashes change in shape, size or color over time. Clarification by a physician is also urgently recommended here. In the case of skin diseases, the dermatologist is the most important contact person. Alternatively, it is possible to see your family doctor. If necessary, this will issue a referral to the dermatologist.

Treatment and therapy

With prompt treatment, the symptoms of exanthema usually resolve quickly. Treatment of contact agent exanthema is simple: avoiding the allergen will relieve the rash. In addition, soothing ointments or creams can be used. Drug exanthema is also treated by discontinuing the allergen, depending on the severity and after weighing the pros and cons. Discontinuation can be problematic if several drugs are taken at the same time, in which case the triggering drug must be identified together with the physician. Taking glucocorticoids or antihistamines supports the healing process. Children’s itches are treated symptomatically. Medications to relieve the itching are administered as a supportive measure until the rash subsides with the end of the illness. If skin diseases are identified as the cause, special therapy is necessary. Local treatment with salicylic acid, taking vitamin D and cortisone preparations or laser therapy are possible. Patients should not start treatment on their own, as over-the-counter antidotes could further irritate the skin. Therapy should be given only after a doctor’s prescription.

Outlook and prognosis

What a patient should expect after a rash depends on its causes. Viral diseases are often responsible for an exanthema. If it is one of the common childhood diseases, the rash usually spreads very quickly over the entire body. Itchy, often watery blisters form, but they do not leave scars unless the patient scratches them open. The disease is usually accompanied by fever, fatigue and body weakness and is overcome after about 14 days. Bacterial infections associated with rashes, such as scarlet fever, often have a similar course but can be treated very well with antibiotics. If the rash is caused by a skin fungus, it often affects other parts of the body. The armpits and the anal and genital regions are particularly affected. The patient is usually referred to a dermatologist, who treats the infected areas with antifungals. Skin fungi must be treated quickly and consistently to prevent them from becoming chronic. Allergic reactions usually subside as soon as contact with the trigger is discontinued. Avoiding allergens, however, almost always entails a change in lifestyle for the patient.

Prevention

When considering preventive measures, a distinction must be made between the different forms of exanthema. Contact and drug exanthema can be prevented only if the risk of disease and the reaction can be apart.While the risk of infectious rashes and triggering STDs can be reduced by practicing good hygiene and avoiding contact with affected individuals, 100% protection against childhood diseases is not possible.

Here’s what you can do yourself

Several measures can help relieve rash. A cooling compress can relieve itchy rash in particular in the short term. Soothing are also ice packs, which, however, should not be placed directly on the skin. Special cooling gels from the pharmacy are also recommended. Skin rashes can be aggravated by constant or severe scratching. Pathogens can penetrate the scratched skin and cause infections. Therefore, people with skin rash should avoid scratching at all costs. Those who cannot stand the itching at all should gently tap, rub or pinch. Short-cut fingernails prevent scratch damage to the skin. Soft cotton gloves can also be worn at night to prevent unconscious scratching. People with rashes should not take hot showers or baths. Hot showers or baths stress the diseased skin. Instead, sufferers should wash with lukewarm or cool water and cleanse their skin only with ph-neutral lotions. Perfume-free aloe vera gel, for example, is well suited. A bath in a salt solution is also helpful. One kilo of sea salt is added to 50 liters of water. Other home remedies for rashes include washing with cold chamomile tea, compresses with cold yogurt, creams containing urea or rubs with olive, sunflower or lavender oil. Freshly crushed coriander leaves or a paste of water and healing clay can also be applied to rashes.