Rash

The Skin Center
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Laguna Hills, CA 92653
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(949) 582-SKIN
Fax (949) 582-7691

RASH
Diplomat, American Board of Dermatology
Fellow, American Society of Mohs Surgery
Fellow, American Academy of Dermatology
Expert Reviewer, Medical Board of California
Former Professor University of California Irvine


PHOTO PSEUDOMONAS FOLLICULITIS BACK: 16 YEAR OLD MALE USING HOT TUBS
TREATED WITH CIRPO 250mg TWICE A DAY FOR 10 DAYS

What is Rash?  Overview:

Rash is a general, non-specific term that describes any visible skin outbreak. Rashes are very common in all ages from infants to seniors, and nearly everyone will have some type of rash at some point in their life. There are a wide variety of different skin rash diagnosis and many different causes.  It is not possible to fully cover every type of rash in such an article. Therefore, special mention has been given to some of the most common types of rashes. A dermatologist is a medical provider who specializes in diseases of the skin and may need to be consulted for rashes that are more difficult to diagnose and treat.

While there are many different types, rashes may basically be divided into two types: infectious or non-infectious.

Non-infectious rashes include eczema, contact dermatitis, psoriasis, seborrheic dermatitis, drug eruptions, rosacea, hives (urticaria), dry skin (xerosis) and allergic dermatitis. Many non-infectious rashes are usually treated with cortisone (steroid) creams and/or pills.

Infection associated rashes such as ringworm (Tinea), impetigo, staphylococcus, scabies, herpes, chicken pox, and shingles are treated by treating the underlying cause. Infectious causes include viral, bacterial, fungal, and parasitic.

The specific type of rash often requires a description of the lesion, shape, arrangement, distribution, duration, symptoms, and history. All of these factors are important in identifying the correct diagnosis.

The reported history will help identify duration of onset, relationship to various environmental factors, skin symptoms (such as itching and pain), and constitutional symptoms such as fever, headache, and chills. Based on the initial impression of a rash, treatment may be started. The treatment may need to be modified pending various laboratory and special skin examinations.

PHOTO SPOTS A FEW DAYS AFTER FREEZING OFF GROWTHS.

Rash Symptoms

Most rashes tend to be itchy. Rashes can be further subdivided into itchy or non-itchy.

A. Types of itchy rashes

  • Hives (Urticaria)

 

PHOTO HIVES- URTICARIA

B. Non-itchy rashes (although these may at times also be itchy)

PHOTO NOTALGIA PARESTHETICA BACK

Rash Appearance

Rashes come in many different colors, sizes, shapes, and patterns. Most rashes tend to be red because of skin inflammation. Rashes may be described as

  • Flat (macular)
  • Raised (papular)
  • Small pus bumps (pustular)
  • Small clear blisters (vesicular)
  • Red or pink
  • Silvery white scales (psoriasis)
  • Annular (circular with central clearing like in ringworm infections)
  • Eczematous (dry, scaly, rough, and thickened)
  • Excoriated (scratched areas)

 

PHOTO: BULLOUS IMPETIGO TRUNK (STAPH)

  1. Non-infectious rashes:
  • Contact dermatitis is by far the most common cause of non-infectious rash. It includes dermatitis like from poison ivy/oak, and allergic skin rashes. External agents such as nickel can typically produce an inflammatory reaction over a period of time causing itching, rash, or burning of the skin. In short term, this type of rash may cause superficial peeling whereas more chronic cases cause thickened patches of skin.
  • Psoriasis typically looks like thickened patches of dry red skin, particularly on the knees, elbows, and nape of the neck. There are many types of psoriasis and this type of rash may uncommonly involve the entire body.

 

PHOTO PSORIASIS

 

PHOTO PSORIASIS

 

Rosacea is a type of adult acne that may cause facial flushing, small pink bumps, and redness of the cheeks, and nose.

  • Lupus related skin findings are known to become exacerbated by sunlight exposure. Lupus can present as red, raised patches or a generalized rash on the nose, ears, cheeks, and base of the nail folds.
  • Seborrheic dermatitis or seborrhea is a common rash that is characterized by redness and scaling of the face, ears, eyebrows, and scalp.
  1. Infectious rashes:
  • Herpes has groups or clusters of small water blisters on a red base.
  • Ringworm (Tinea) has dry, red patches with dry skin flakes. Often there is central clearing creating a donut pattern (annular).

 

Rash Causes

Skin rashes have an exhaustive list of potential causes including infections.  In a broad sense, rashes are commonly categorized as infectious or non-infectious.

 

A.  Infectious rashes include:

  • Fungal

-Trichophyton is a type of skin fungus that commonly causes rashes of the skin, hair and nails. This infectious rash is called tinea or “ringworm”.

-Candida can cause common yeast infections in moist areas like between the fingers, in the mouth, vaginal area, and also the groin folds.

-Other much less common fungal infections include Cryptococcus, Aspergillus, and Histoplasmosis. These are fairly uncommon in healthy people and more seen in individuals with a compromised immune system like with HIV/AIDS, and cancer therapy immunosuppression.

 

  • Viral

-Herpes simplex types I and II may cause infections of the lips, nose, facial skin, genitals, and buttocks.

-Herpes zoster causes chicken pox and shingles.

-HIV causes many types of rashes, both nonspecific viral reactions as well as infection associated rashes.

-Epstein-Barr virus is associated with many types of rashes and most commonly with mononucleosis (“mono” or “kissing disease”).

- Many viruses including Parvovirus and Coxsackie virus cause rashes. Coxsackie virus is associated with Hand Foot and Mouth Disease (HFMD).Young children are particularly prone to many kinds of viral infections and illnesses.

 

  • Bacterial

-Staphylococcus infections are extremely common and may cause many types of rashes including folliculitis, abscesses, furuncles, cellulitis, impetigo, Staph Scalded Skin Syndrome, and surgical wound infections.

- Streptococcus infection may cause strep throat, Scarlet Fever , other skin infections, cellulitis, and necrotizing fasciitis.

- Pseudomonas may causes all sorts of skin issues including green discoloration of the nails, folliculitis, hot tub folliculitis, surgical wound infections, and foot infections following a penetrating injury through tennis shoes.

- Many other types of less common bacteria cause skin rashes. These are often diagnosed on skin culture.

-Parasitic

- Scabies is a very itchy, contagious, superficial skin infestation with a microscopic mite.

- Lice infestations may cause different types of itchy rashes in the affected areas like scalp and nape of the neck.

 

 

B. Non-infectious rashes

  • Drug allergies may arise from exposure to drugs containing sulfa, penicillin, anti- seizure medications like phenytoin and phenobarbital, and many others.
    • Contact allergic dermatitis may develop on repeat exposure to topical products like nickel, neomycin, cobalt, fragrance, adhesives, latex, rubber, and dyes. Essentially any product may potentially induce a skin allergy.
    • Eczema or atopic dermatitis includes a wide variety of skin sensitivity where the skin in parts is dry, red, and itchy.
    • Hypersensitivity or allergic dermatitis may develop upon repeat exposure to poison oak and poison ivy.
    • Irritant dermatitis from excess skin dryness may develop from repeat exposure to harsh soaps and cleaning chemicals.
    • Autoimmune conditions, like Systemic Lupus Erythematosus (SLE), Hashimoto’s thyroiditis, Scleroderma, and other disorders where the immune system may be overactive, often cause skin rashes.
    • Other internal diseases such as amyloidosis and sarcoidosis may cause skin symptoms and accompanying rashes.

 

Exams and Tests

There are many useful laboratory and special examinations which are helpful in diagnosis of rash.

  • Bacterial culture to check for bacteria on the skin or in a wound
  • Microscopic examination of skin with potassium hydroxide to look for fungus
  • Blood tests such as antinuclear antibody (ANA), complete blood count (CBC), liver function tests (LFT), and thyroid function tests
  • Nasal culture to check for staph and other bacteria using a cotton tip swab
  • Gram stain to look for bacteria types
  • Tzanck Prep to look for herpes virus under the microscope
  • Skin biopsy (small skin scraping sent for histology)
  • Patch test to determine contact allergies

 

MICROSCOPY SHOWING POSITIVE TEST FOR FUNGUS

 

Sampling skin material and viewing under direct microscopy is a fast and simple way to help diagnose a rash. When a superficial fungal or yeast infection is suspected, viewing a superficial skin scraping with potassium hydroxide prep can exhibit fungal hyphae or budding cells.

Likewise, suspected bacterial infection can be checked by a Gram stain or nasal swab culture. Viral lesions seen typically caused by Herpes simplex can be viewed under the microscope with a Tzanck smear which will show giant, multinucleate cells.

Blood tests can be helpful as well (i.e. sudden onset of severe psoriasis may be associated with an HIV infection.) Anti-streptolysin O (ASO) levels can be helpful in detecting a sudden onset of guttate psoriasis associated with a prior streptococcal throat infection.

 

Rash Treatment

In general, most non-infectious rashes are usually treated symptomatically and often with cortisone creams and/or pills. Infection associated rashes are frequently treated by addressing the underlying infection.

A.  Infectious rashes:

  • Fungal

-Tinea or ringworm infections of the skin, hair and nails are treated by topical and or oral antifungal medications like terbinafine.

-Candida infections (“yeast”) are treated with topical antifungal medications like clotrimazole and sometimes with oral anti-fungals like fluconazole.

-Atypical fungal infections including Cryptococcus, Aspergillus, and Histoplasmosis are generally treated with an oral or intravenous course of special antifungal medications.

  • Viral

-Herpes infections are usually treated with oral or intravenous anti-viral medications including acyclovir, famciclovir, valacyclovir, gangcyclovir, and cidofovir. Depending on the severity of the individual infection, specific anti-viral treatment may not be required.

-Vaccination is an effective prevention measure to help ward off infections with the Herpes zoster virus which causes chicken pox and shingles.

- There is no currently vaccine available for Herpes Simplex.

-HIV infections are treated with a special combination of anti-viral medications designed specifically for this virus.

- Many other viral infections are self-limited and often may clear even without any treatment.

  • Bacterial

-Staphylococcus infections are typically treated with penicillin and cephalosporin type antibiotics. Topical treatment may include mupirocen cream or ointment.

- A resistant form of Staphylococcus called methicillin-resistant-Staphylococcus- aureus (MRSA) is treated based on specific antibiotic testing. Common antibiotics for MRSA include doxycycline, sulfamethoxasole-trimethoprim, and vancomycin.

- Streptococcus infections are typically treated with oral or injectable antibiotics including penicillin and erythromycin.

- Pseudomonas infections are treated with oral or intravenous antibiotics including ciprofloxacin or ofloxacin.

 

B. Non-infectious rashes

  • Drug allergy rash treatment includes stopping the responsible drug. Sometimes, a short course of oral steroids may be required in severe cases to help clear the rash.
    • Contact allergic dermatitis therapy includes withdrawal of the offending topical agent and use of topical steroids creams like clobetasol or hydrocortisone cream.
    • Eczema or atopic dermatitis treatment include a wide variety of skin care including lubrication and topical steroids, as well as oral antihistamines like  diphenhydramine ( Benadryl) for itching.
    • Hypersensitivity or allergic dermatitis from poison oak and poison ivy is treated by washing off the plant’s oily resin from the skin, clothing, and objects like golf clubs or shoes and applying steroid creams to the rash two to three times a day. Severe cases may require oral steroids like prednisone.
    • Irritant dermatitis treatment includes skin lubrication, avoidance of harsh soaps and chemicals, use of petrolatum (Vaseline), and topical steroids like hydrocortisone.
    • Autoimmune conditions Lupus (SLE) are treated by addressing the overactive immune reaction. Often oral and topical steroids are used to help control symptoms. Additional medications include hydroxychloroquine.

Self-Care at Home

A. Eczema

  • Hydrocortisone cream
  • Use of soapless cleansers like Cetaphil or Dove
  • Emollients such as Crisco Vegetable Shortening and Vaseline
  • Benadryl for itching

 

B.  Fungal infections

  • ketoconazole shampoo to wash the affected areas
  • clotrimazole cream or terbinafine spray twice a day
  • Benadryl for itching

 

C.  Bacterial infections

  • Dilute vinegar soaks to affected area– mix 4 parts water and 1 part white vinegar
  • Dilute Clorox  bleach bath – one quarter cup Clorox regular bleach in one bathtub full warm water  for skin infections
  • Chlorhexidine (Hibiclens) washes twice a day to affected area
  • Neomycin or bacitracin two-three times a day

 

Medications

Individuals should consider consulting with their health care provider before starting any medications.

A. Eczema

  • Steroid creams like clobetasol, triamcinolone, and hydrocortisone

B.Fungal infections

  • clotrimazole
  • terbinafine
  • ketoconazole

C. Bacterial infections

  • Staphylococcus infections -  cephalexin
  • Pseudomonas infection – ciprofloxacin
  • MRSA infection – doxycycline, trimethoprim- sulfamethoxisole

 

Prevention

Eczema – Avoid offending or irritating agents like harsh soaps and cleansers in contact dermatitis. Patch testing with special allergens should be done if there is suspicion for topical allergies. Keep the affected area moist with cream/ointment or emollients.

Viral infection – Avoid infected people especially with active chickenpox. Some viral infections can cause harm in pregnancy to the unborn fetus. Bodily fluids such as blood, respiratory droplets, and saliva also should be avoided to prevent infection.

Bacterial infection – Hand washing and proper hygiene are very important in prevention. Avoid shaving with dirty razors. Use special precautions in public facilities including gyms, showers, and pools to help prevent infections.

 

Outlook

The outlook for rash depends on the underlying cause. Most rashes are short lived and easily resolve. There are some chronic rashes that are not curable like psoriasis. Medical monitoring is often necessary to watch the progression of more resistant or recurrent rashes. Any persistent rashes or refractory to appropriate treatment may warrant a skin biopsy to rule out cancer.

 




RASH   Rev. 6-3-09  

Rash Overview
Rash is a general, non-specific term that describes any visible skin outbreak. Rashes are very common in all ages from infants to seniors, and nearly everyone will have some type of rash at some point in their life. There are a wide variety of different skin rash diagnosis and many different causes.  It is not possible to fully cover every type of rash in such an article. Therefore, special mention has been given to some of the most common types of rashes. A dermatologist is a medical provider who specializes in diseases of the skin and may need to be consulted for rashes that are more difficult to diagnose and treat.

While there are many different types, rashes may basically be divided into two types: infectious or non-infectious. 

Non-infectious rashes include eczema, contact dermatitis, psoriasis, seborrheic dermatitis, drug eruptions, rosacea, hives (urticaria), dry skin (xerosis) and allergic dermatitis. Many non-infectious rashes are usually treated with cortisone (steroid) creams and/or pills.

Infection associated rashes such as ringworm (Tinea), impetigo, staphylococcus, scabies, herpes, chicken pox, and shingles are treated by treating the underlying cause. Infectious causes include viral, bacterial, fungal, and parasitic.

The specific type of rash often requires a description of the lesion, shape, arrangement, distribution, duration, symptoms, and history. All of these factors are important in identifying the correct diagnosis.

STAPH FOLLICULITIS UNDERARM

The reported history will help identify duration of onset, relationship to various environmental factors, skin symptoms (such as itching and pain), and constitutional symptoms such as fever, headache, and chills. Based on the initial impression of a rash, treatment may be started. The treatment may need to be modified pending various laboratory and special skin examinations.

Rash Symptoms

Most rashes tend to be itchy. Rashes can be further subdivided into itchy or non-itchy.

A. Types of itchy rashes

  • Hives (Urticaria)
  • Bug bites
  • Scabies (Mite infestation)
  • Eczema (Skin allergy)

B. Non-itchy rashes (although these may at times also be itchy)

  • Rosacea
  • Psoriasis

 

 SEVERE PLAQUE PSORIASIS ON LEG

Rash Appearance

Rashes come in many different colors, sizes, shapes, and patterns. Most rashes tend to be red because of skin inflammation. Rashes may be described as

  • Flat (macular)
  • Raised (papular)
  • Small pus bumps (pustular)
  • Small clear blisters (vesicular)
  • Red or pink
  • Silvery white scales (psoriasis)
  • Annular (circular with central clearing like in ringworm infections)
  • Eczematous (dry, scaly, rough, and thickened)
  • Excoriated (scratched areas)
- Non-infectious rashes:
  • Contact dermatitis is by far the most common cause of non-infectious rash. It includes dermatitis like from poison ivy/oak, and allergic skin rashes. External agents such as nickel can typically produce an inflammatory reaction over a period of time causing itching, rash, or burning of the skin. In short term, this type of rash may cause superficial peeling whereas more chronic cases cause thickened patches of skin.
  • Psoriasis typically looks like thickened patches of dry red skin, particularly on the knees, elbows, and nape of the neck. There are many types of psoriasis and this type of rash may uncommonly involve the entire body.
  • Rosacea is a type of adult acne that may cause facial flushing, small pink bumps, and redness of the cheeks, and nose.
  • Lupus related skin findings are known to become exacerbated by sunlight exposure. Lupus can present as red, raised patches or a generalized rash on the nose, ears, cheeks, and base of the nail folds.
  • Seborrheic dermatitis or seborrhea is a common rash that is characterized by redness and scaling of the face, ears, eyebrows, and scalp.

- Infectious rashes:

  • Herpes has groups or clusters of small water blisters on a red base.
  • Ringworm (Tinea) has dry, red patches with dry skin flakes. Often there is central clearing creating a donut pattern (annular).

Rash Causes

Skin rashes have an exhaustive list of potential causes including infections.  In a broad sense, rashes are commonly categorized as infectious or non-infectious.

A.  Infectious rashes include:

  • Fungal

-Trichophyton is a type of skin fungus that commonly causes rashes of the skin, hair and nails. This infectious rash is called tinea or “ringworm”.

-Candida can cause common yeast infections in moist areas like between the fingers, in the mouth, vaginal area, and also the groin folds.

-Other much less common fungal infections include Cryptococcus, Aspergillus, and Histoplasmosis. These are fairly uncommon in healthy people and more seen in individuals with a compromised immune system like with HIV/AIDS, and cancer therapy immunosuppression.

  • Viral

-Herpes simplex types I and II may cause infections of the lips, nose, facial skin, genitals, and buttocks.

-Herpes zoster causes chicken pox and shingles.

-HIV causes many types of rashes, both nonspecific viral reactions as well as infection associated rashes.

-Epstein-Barr virus is associated with many types of rashes and most commonly with mononucleosis (“mono” or “kissing disease”).

- Many viruses including Parvovirus and Coxsackie virus cause rashes. Coxsackie virus is associated with Hand Foot and Mouth Disease (HFMD).Young children are particularly prone to many kinds of viral infections and illnesses.

  • Bacterial

 -Staphylococcus infections are extremely common and may cause many types of rashes including folliculitis, abscesses, furuncles, cellulitis, impetigo, Staph Scalded Skin Syndrome, and surgical wound infections.

- Streptococcus infection may cause strep throat, Scarlet Fever , other skin infections, cellulitis, and necrotizing fasciitis.

- Pseudomonas may causes all sorts of skin issues including green discoloration of the nails, folliculitis, hot tub folliculitis, surgical wound infections, and foot infections following a penetrating injury through tennis shoes.

- Many other types of less common bacteria cause skin rashes. These are often diagnosed on skin culture.

  • Parasitic

-Scabies is a very itchy, contagious, superficial skin infestation with a microscopic mite.

 

 

Lice infestations may cause different types of itchy rashes in the affected areas like scalp and nape of the neck.

B. Non-infectious rashes

  • Drug allergies may arise from exposure to drugs containing sulfa, penicillin, anti- seizure medications like phenytoin and phenobarbital, and many others.
    • Contact allergic dermatitis may develop on repeat exposure to topical products like nickel, neomycin, cobalt, fragrance, adhesives, latex, rubber, and dyes. Essentially any product may potentially induce a skin allergy.
    • Eczema or atopic dermatitis includes a wide variety of skin sensitivity where the skin in parts is dry, red, and itchy.
    • Hypersensitivity or allergic dermatitis may develop upon repeat exposure to poison oak and poison ivy.
    • Irritant dermatitis from excess skin dryness may develop from repeat exposure to harsh soaps and cleaning chemicals.
    • Autoimmune conditions, like Systemic Lupus Erythematosus (SLE), Hashimoto’s thyroiditis, Scleroderma, and other disorders where the immune system may be overactive, often cause skin rashes.
    • Other internal diseases such as amyloidosis and sarcoidosis may cause skin symptoms and accompanying rashes.

Exams and Tests

There are many useful laboratory and special examinations which are helpful in diagnosis of rash.

  • Bacterial culture to check for bacteria on the skin or in a wound
  • Microscopic examination of skin with potassium hydroxide to look for fungus

 

  • Blood tests such as antinuclear antibody (ANA), complete blood count (CBC), liver function tests (LFT), and thyroid function tests
  • Nasal culture to check for staph and other bacteria using a cotton tip swab
  • Gram stain to look for bacteria types
  • Tzanck Prep to look for herpes virus under the microscope
  • Skin biopsy (small skin scraping sent for histology)
  • Patch test to determine contact allergies

Sampling skin material and viewing under direct microscopy is a fast and simple way to help diagnose a rash. When a superficial fungal or yeast infection is suspected, viewing a superficial skin scraping with potassium hydroxide prep can exhibit fungal hyphae or budding cells.

Likewise, suspected bacterial infection can be checked by a Gram stain or nasal swab culture. Viral lesions seen typically caused by Herpes simplex can be viewed under the microscope with a Tzanck smear which will show giant, multinucleate cells.

Blood tests can be helpful as well (i.e. sudden onset of severe psoriasis may be associated with an HIV infection.) Anti-streptolysin O (ASO) levels can be helpful in detecting a sudden onset of guttate psoriasis associated with a prior streptococcal throat infection.

Rash Treatment

In general, most non-infectious rashes are usually treated symptomatically and often with cortisone creams and/or pills. Infection associated rashes are frequently treated by addressing the underlying infection.

A.  Infectious rashes:

  • Fungal

-Tinea or ringworm infections of the skin, hair and nails are treated by topical and or oral antifungal medications like terbinafine.

-Candida infections (“yeast”) are treated with topical antifungal medications like clotrimazole and sometimes with oral anti-fungals like fluconazole.

-Atypical fungal infections including Cryptococcus, Aspergillus, and Histoplasmosis are generally treated with an oral or intravenous course of special antifungal medications.

  • Viral

-Herpes infections are usually treated with oral or intravenous anti-viral medications including acyclovir, famciclovir, valacyclovir, gangcyclovir, and cidofovir. Depending on the severity of the individual infection, specific anti-viral treatment may not be required.

-Vaccination is an effective prevention measure to help ward off infections with the Herpes zoster virus which causes chicken pox and shingles.

- There is no currently vaccine available for Herpes Simplex.

-HIV infections are treated with a special combination of anti-viral medications designed specifically for this virus.

- Many other viral infections are self-limited and often may clear even without any treatment.

  • Bacterial

 -Staphylococcus infections are typically treated with penicillin and cephalosporin type antibiotics. Topical treatment may include mupirocen cream or ointment.  

- A resistant form of Staphylococcus called methicillin-resistant-Staphylococcus- aureus (MRSA) is treated based on specific antibiotic testing. Common antibiotics for MRSA include doxycycline, sulfamethoxasole-trimethoprim, and vancomycin.

- Streptococcus infections are typically treated with oral or injectable antibiotics including penicillin and erythromycin.

- Pseudomonas infections are treated with oral or intravenous antibiotics including ciprofloxacin or ofloxacin.

B. Non-infectious rashes

  • Drug allergy rash treatment includes stopping the responsible drug. Sometimes, a short course of oral steroids may be required in severe cases to help clear the rash.
    • Contact allergic dermatitis therapy includes withdrawal of the offending topical agent and use of topical steroids creams like clobetasol or hydrocortisone cream.
    • Eczema or atopic dermatitis treatment include a wide variety of skin care including lubrication and topical steroids, as well as oral antihistamines like  diphenhydramine ( Benadryl) for itching.
    • Hypersensitivity or allergic dermatitis from poison oak and poison ivy is treated by washing off the plant’s oily resin from the skin, clothing, and objects like golf clubs or shoes and applying steroid creams to the rash two to three times a day. Severe cases may require oral steroids like prednisone.
    • Irritant dermatitis treatment includes skin lubrication, avoidance of harsh soaps and chemicals, use of petrolatum (Vaseline), and topical steroids like hydrocortisone.
    • Autoimmune conditions Lupus (SLE) are treated by addressing the overactive immune reaction. Often oral and topical steroids are used to help control symptoms. Additional medications include hydroxychloroquine.

Self-Care at Home

A. Eczema

  • Hydrocortisone cream
  • Use of soapless cleansers like Cetaphil or Dove
  • Emollients such as Crisco Vegetable Shortening and Vaseline
  • Benadryl for itching

B.  Fungal infections

  • ketoconazole shampoo to wash the affected areas
  • clotrimazole cream or terbinafine spray twice a day
  • Benadryl for itching

C.  Bacterial infections

  • Dilute vinegar soaks to affected area– mix 4 parts water and 1 part white vinegar
  • Dilute Clorox  bleach bath – one quarter cup Clorox regular bleach in one bathtub full warm water  for skin infections
  • Chlorhexidine (Hibiclens) washes twice a day to affected area
  • Neomycin or bacitracin two-three times a day

Medications

Individuals should consider consulting with their health care provider before starting any medications.

A. Eczema

  • Steroid creams like clobetasol, triamcinolone, and hydrocortisone

B.Fungal infections

  • clotrimazole
  • terbinafine
  • ketoconazole

C. Bacterial infections

  • Staphylococcus infections -  cephalexin
  • Pseudomonas infection – ciprofloxacin
  • MRSA infection – doxycycline, trimethoprim- sulfamethoxisole

Prevention

Eczema – Avoid offending or irritating agents like harsh soaps and cleansers in contact dermatitis. Patch testing with special allergens should be done if there is suspicion for topical allergies. Keep the affected area moist with cream/ointment or emollients.

Viral infection – Avoid infected people especially with active chickenpox. Some viral infections can cause harm in pregnancy to the unborn fetus. Bodily fluids such as blood, respiratory droplets, and saliva also should be avoided to prevent infection.

Bacterial infection – Hand washing and proper hygiene are very important in prevention. Avoid shaving with dirty razors. Use special precautions in public facilities including gyms, showers, and pools to help prevent infections.

Outlook

The outlook for rash depends on the underlying cause. Most rashes are short lived and easily resolve. There are some chronic rashes that are not curable like psoriasis. Medical monitoring is often necessary to watch the progression of more resistant or recurrent rashes. Any persistent rashes or refractory to appropriate treatment may warrant a skin biopsy to rule out cancer.


Information in this publication and site is not intended to serve as medical advice. Individuals may use the information as a guide to discuss their treatments with their own physicians. This site does not promote nor endorse the unauthorized practice of medicine by non-physicians or state licensed health care providers.

Medicine is a constantly changing science and not all therapies are clearly established. New research changes drug and treatment therapies daily. The authors, editors, and publisher of these articles have used their best efforts to provide information that is up-to-date and accurate and is generally accepted within medical standards at the time of publication. However, as medical science is constantly changing and human error is always possible, the authors, editors, and publisher or any other party involved with the publication of this article do not warrant the information in this article is accurate or complete, nor are they responsible for omissions or errors in the article or for the results of using this information. The reader should confirm the information in this article from other sources prior to use. In particular, all drug doses, indications, and contraindications should be confirmed in the package insert.

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