General approach to rashes: Difference between revisions

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*[[Allergic Reaction]]
''This page is for adult patients; for other age groups see [[pediatric rashes]] and [[neonatal rashes]]''
*[[Dermititis Herpetiformis]]
==Background==
*[[Erysipelas]]
{{Skin anatomy background images}}
*[[Impetigo]]
[[File:3D medical animation skin layers.jpg|thumb|3D medical illustration showing major layers of skin]]
*[[Pityriasis Rosea]]
*A wide range of benign and dangerous pathology can present with a rash
*[[Scabies]]
 
*[[Serum Sickness]]
{{Rash red flags}}
*[[Stevens Johnson Syndrome and Toxic Epidermal Necrolysis]]
{{Primary derm lesions names}}
 
==Clinical Features==
===History===
*Key elements from the history include:
**Distribution and progression of the skin lesions
**Recent exposures (sick contacts, foreign travel, sexual history and vaccination status)
**Any new medications
 
===Physical Exam===
*Pay specific attention to vital signs
**A rash associated with fever or hypotension should make you worry about potentially deadly diagnoses
*Perform a careful physical exam
**Undressing the patient to fully examine the trunk and the extremities
**Look at palms, soles and mucous membranes
**Touch the skin with a gloved hand to determine if the lesions are flat or raised
**Press on lesions to see whether they blanch
**Rub erythematous skin to see if it sloughs
 
==Differential Diagnosis==
{{Maculopapular rash DDX}}
{{Bullous rashes DDX}}
{{Necrotizing Rashes DDX}}
{{Purpura DDX}}
{{Erythematous rash DDX}}
{{DDX dark raised lesions}}
{{Generalized rash DDX}}
{{Plaques DDX}}
 
==Evaluation==
[[File:Dermatologic Emergencies.png|1500px|Algorithm for the Evaluation of Dermatologic Emergencies]]
{{Maculopapular rashes images}}
{{Bullous rashes images}}
{{Erythematous rashes images}}
{{Purpura rash images}}
{{Dark raised skin lesions images}}
{{General rashes images}}
 
==Management==
*Based on diagnosis
 
==Disposition==
*Based on diagnosis
 
==See Also==
*[[Fever and rash]]
*[[Pediatric rashes]]
*[[Visual diagnosis (main)]]
*[[Ulcerative STDs]]
*[[Ulcerative STDs]]
*[[Vitiligo]]
*[[Dermatologic nomenclature]]
ftp://google.com
*[[Pigmented rashes]]
==See Also==
*[[Rashes of pregnancy]]
*[[Fever and Rash]]
 
*[[Pediatric Rashes]]
==External Links==
*[http://www.emdocs.net/9009-2/ EMDOCS: What's that rash? An approach to dangerous rashes based on morphology.]
 
==References==
<references/>


[[Category:Derm]]
[[Category:Dermatology]]
[[Category:Symptoms]]

Latest revision as of 16:35, 11 December 2024

This page is for adult patients; for other age groups see pediatric rashes and neonatal rashes

Background

Normal dermal anatomy.
3D medical illustration showing major layers of skin
  • A wide range of benign and dangerous pathology can present with a rash

Rash Red Flags[1]

Dermatology Nomenclature

Small lesions (<0.5cm)

Name Raised/Palpable Fluid-Filled Other Description Diagram
Macule No None flat, cirumscribed, colored Macule.png
Papule Yes None Solid Papule.png
Vesicle Yes Clear Vesicles (2).png
Pustule Yes Pus Leukocytes or keratin Pustules.png

Large lesions (>0.5cm)

Name Raised/Palpable Fluid-Filled Other Description Diagram
Patch No None Large macule (flat, colored) Patch.png
Plaque Yes None Superficially raised, circumscribed solid area Plaque.png
Nodule Yes None Distinct large papule Nodules.png.png
Bulla Yes Clear Large vesicle/blister or exposed epidermal layer Bulla.png
Wheal Yes Edema Firm and edema of dermis

Other

Ulcer, fissue, and erosion

Clinical Features

History

  • Key elements from the history include:
    • Distribution and progression of the skin lesions
    • Recent exposures (sick contacts, foreign travel, sexual history and vaccination status)
    • Any new medications

Physical Exam

  • Pay specific attention to vital signs
    • A rash associated with fever or hypotension should make you worry about potentially deadly diagnoses
  • Perform a careful physical exam
    • Undressing the patient to fully examine the trunk and the extremities
    • Look at palms, soles and mucous membranes
    • Touch the skin with a gloved hand to determine if the lesions are flat or raised
    • Press on lesions to see whether they blanch
    • Rub erythematous skin to see if it sloughs

Differential Diagnosis

Maculopapular rashes


Vesiculobullous rashes

Febrile

Afebrile

Necrotizing rashes

Petechiae/Purpura (by cause)

Erythematous rash

Dark raised skin lesions

Other Rash

Plaques

Evaluation

Algorithm for the Evaluation of Dermatologic Emergencies

Maculopapular rashes visual diagnosis


Vesiculobullous rashes visual diagnosis

Erythematous rash

Purpural Rash

Dark raised skin lesions

Other Rash visual diagnosis

Management

  • Based on diagnosis

Disposition

  • Based on diagnosis

See Also

External Links

References

  1. ↑ Nguyen T and Freedman J. Dermatologic Emergencies: Diagnosing and Managing Life-Threatening Rashes. Emergency Medicine Practice. September 2002 volume 4 no 9.
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