Hundreds of reasons for rashes make it difficult for even dermatologists to accurately diagnose without the benefit of a laboratory. How will we determine whether a rash is cause for concern or how to treat it?
Generalized Rash with Sudden Onset
This is the most concerning and is either due to an allergic reaction or an infection. Or it could be that an infection is treated with a medication to which the patient has an allergic reaction that manifests as a rash.
The allergic reaction may be caused by medication (oral, injected, or inhaled) such as antibiotics (penicillin is a common culprit), tranquilizers, pain relievers, or even insulin; foods like nuts and shellfish, or chemical fumes. The rash may begin within minutes or weeks after exposure.[1] The typical allergic rash is red with some parts raised and others flat. It may look like eczema, hives, bull’s eye-like lesions or blisters varying in size.
Viral rashes usually develop after an illness begins. The rashes may be specific and characteristic of measles, chickenpox, or smallpox. Or they may be non-specific and develop following an upper respiratory infection or gastrointestinal symptoms. Most generalized rashes caused by infections start in the head and neck area and gradually travel down to cover the rest of the body. The lesions are smooth and no scales form. If related to an upper respiratory infection, the lymph nodes in the neck may be tender and/or enlarged. The tongue may be smooth and red. Red dots may appear on the roof of the mouth. The rash lasts 5-10 days. [2]
The most important question to consider with a rash is the patient’s condition. Is he “well” or “unwell”? Do vital signs and history suggest the possibility of anaphylaxis? [3] If so, the patient may need treatment with an epi-pen. Or does the patient have a fever, which is more indicative of an infection? If there are no other concerning symptoms, such as altered conscious state or irregular vital signs, the rash is usually benign.[4]
In a “well” patient, if the rash does not have a clear cause, it can be treated with antihistamines, cooling the skin, and avoiding hot or sweaty clothes.[5]
Localized Red Rashes
Rashes in the armpits or groin or between the toes are often fungal infections, which proliferate in warm, damp environments. Treat with a topical anti-fungal like clotrimoxazole.[6]
A localized, itchy red rash is often due to allergic dermatitis or eczema. And antihistamine may relieve the itching. Apply a steroid cream like hydrocortisone to the rash. Also, moisturize the skin and keep it slightly oily. Long hot showers and too much soap are irritating.[7]
Finally, a primary principle of rash management is as follows:
“If it is wet, dry it. If it is dry, wet it.”
“Wet” a rash with a moisturizing cream that has fats or an emollient base. Make your own with coconut or olive oil or tallow and beeswax. The cover, if desired, with an occlusive dressing (or a nitrile glove or plastic wrap).
“Dry” a rash with exposure to sunlight and fresh air.[8]
Calendula salve is widely considered the best herbal treatment for skin rashes.
An article with brief rash descriptions and symptoms accompanying clinically significant rashes will follow.
Links to related posts:
The Medicinal Uses of Calendula
Two DIY Tests for Food Allergies
[1] Ship’s Medicine Chest and Medical Aid at Sea, 1978, 233.
[2] Ship’s Medicine Chest and Medical Aid at Sea, 1978, 233.
[3] Survival and Austere Medicine, 3rd Edition, 2017, 145.
[4] Survival and Austere Medicine, 3rd Edition, 2017, 146.
[5] Survival and Austere Medicine, 3rd Edition, 2017, 146.
[6] Survival and Austere Medicine, 3rd Edition, 2017, 145.
[7] Survival and Austere Medicine, 3rd Edition, 2017, 145.
[8] Survival and Austere Medicine, 3rd Edition, 2017, 145.
I find that application of vinegar often an easy cure for toe-foot-armpit and crotch fungus-rashes. Stings but works pretty fast.
ReplyDeleteI can make vinegar but not antifungals.
I didn't notice rashes from contact dermatitis from poison oak and such mentioned. If there is a possibility of that or other chemical issues a careful soap and water washing is required.
Then search out with questioning where that problem is as to prevent more occurrences.
Rashes can also be from stress. Again, the human nursing touch is useful here.