From the Guidelines
Rashes are a polymorphic pattern of cutaneous inflammation that can manifest as red patches, bumps, blisters, scales, or other abnormalities on the skin surface, as described in the British Association of Dermatologists' guidelines for the management of contact dermatitis 2017 1.
Characteristics of Rashes
Rashes can be localized to a specific area or spread across the body, and can be itchy, painful, or asymptomatic. Common causes include:
- Allergic reactions
- Infections (bacterial, viral, or fungal)
- Medications
- Autoimmune conditions
- Heat
- Irritants
Treatment of Rashes
Treatment depends on the underlying cause but often includes:
- Topical corticosteroids like hydrocortisone 1% cream applied twice daily for 7-10 days for mild inflammatory rashes
- Antihistamines such as diphenhydramine (25-50mg every 6 hours) or cetirizine (10mg daily) to help relieve itching
- Antifungal creams like clotrimazole or miconazole applied twice daily for 2-4 weeks for fungal rashes
- Antibiotics for bacterial skin infections
Management of Rashes
It's essential to:
- Avoid scratching
- Keep the affected area clean
- Wear loose clothing
- Identify and avoid triggers
- Seek immediate medical attention if the rash is severe, spreads rapidly, is accompanied by fever, blisters, or affects breathing, as these could indicate a serious condition requiring specialized treatment, as noted in the guidelines for the management of atopic dermatitis 1 and contact dermatitis 1.
From the Research
Types of Rashes
- Acute generalized exanthematous pustulosis (AGEP) is a rare cutaneous eruption which is often provoked by drugs 2
- Allergic contact dermatitis is a common cause of rashes, with topical medicaments being a frequent culprit 3
- Maculopapular skin rash is a common cutaneous allergic drug reaction, often caused by antibiotics 4
- Urticaria is another type of rash that can be caused by drug hypersensitivity reactions 4
Causes of Rashes
- Systemic corticosteroids can induce AGEP 2
- Topical medicaments, such as antibiotics, steroids, anesthetics, and antifungals, can cause allergic contact dermatitis 3
- Drugs such as ampicillin, amoxicillin, and clavulanic acid can cause cutaneous allergic drug reactions 4
- Biologics and targeted therapies can also cause side effects, including rashes 4
Characteristics of Rashes
- AGEP is characterized by rapidly spreading pustular eruptions, accompanied by malaise, fever, and neutrophilia 2
- Allergic contact dermatitis can cause a range of symptoms, from mild redness and itching to severe blistering and ulceration 3
- Maculopapular skin rash is typically characterized by a flat, red rash that may be accompanied by itching or burning 4
- Urticaria is characterized by itchy, raised welts that can appear anywhere on the body 4
Treatment and Management of Rashes
- Topical steroids can be effective in treating rashes, such as AGEP and allergic contact dermatitis 2, 3
- Avoiding the causative agent is crucial in preventing further reactions 3, 4
- In some cases, alternative treatments, such as oral antihistamines or corticosteroids, may be necessary to manage symptoms 4, 5