How to Identify 9 Common Skin Rash

Pictures of Common Rashes

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Understanding Rash and Their Causes

Used under a Creative Commons license at https://en.wikipedia.org/wiki/Itch#/media/File:Itch.jpg
Orrling and Tomer S.

A rash is a reaction in which the skin will develop an abnormal texture and other features, usually in response to a toxin, drug, disease, light, or any number of common or uncommon environmental factors. A rash's appearance can be as varied as its cause, ranging from minor bumps and hives to potentially serious, all-body outbreak.

The look and location of a rash can often give us clues as to what the cause may be. Here are some of the more common rashes, including tips on how to identify and treat them:

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Hives (Urticaria)

Hive (urticaria). Heather L. Brannon, MD

There are times when an allergic reaction or infection will cause skin cells to release a substance called histamine into the blood stream, When this happens, tiny blood vessels, called capillaries, will leak fluid into the top (epidermal) layer of the skin. This accumulation of fluid will cause parts of the skin to swell and turn into hives (urticaria). Depending on the amount of fluid released, hives can look spongy or appear as raised areas of inflamed skin with no distinct border.

Hives can also develop as a result of sun or cold exposure, infections, excessive perspiration, and stress. While hives usually go away on their own, antihistamines may be useful relieving itching and inflammation.

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Impetigo

Impetigo. Heather L. Brannon, MD

Impetigo is a common infection of the skin that is caused by either a streptococcal or staphylococcal bacteria.The most common form of impetigo occurs on the face or limbs and is characterized by a honey-colored crust caused by the eruption of tiny blisters. The bacteria typically enter the body through broken or abraded skin such as can happen with cuts, burns, eczema, poison ivy, or insect bites. Children often get impetigo after a cold when their nose is raw and inflamed. 

A less common can cause involves the formation of large blisters called bullae. This form of impetigo tends to occur more in newborns and younger children than adults. As a bacterial infection, impetigo is typically treated with antibiotics.

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Shingles (Herpes Zoster)

Shingles (herpes zoster). Marie Griffiths

Shingles is a painful rash caused by a reactivation of the herpes zoster virus (HZV), the same virus which causes chicken pox. The lifetime risk of developing shingles rash is anywhere from 10 percent to over 20 percent in some high-risk groups. Shingles typically happen later in life, often starting with a dull, localized ache. Soon after, a distinctive patch of tiny blisters will develop, many of which will burst open and a form inflamed, crusted ulcers.

Shingles tend to appear on one side of the body or next, running along the nerve string called a dermatome. Even if an outbreak doesn't seem all that painful at first, it can result in severe, long-term pain (known as postherpetic neuralgia) if left untreated.

See a doctor as soon as you recognize the characteristic fluid-filled blisters. Early treatment with antiviral drugs may shorten the duration of an outbreak and prevent the spread of the rash to vulnerable parts of the body, including the eyes.

An effective shingles vaccine called Zostavax ​is recommended for all adults 50 and older.

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Athlete's Foot (Tinea Pedis)

Athlete's Foot (tinea pedis). Dr. Gnu

Athlete's foot, or tinea pedis, is a common fungal infection. The characteristic symptoms include an itchy, red rash, primarily between the toes or on the soles of the feet. Chronic tinea pedis can sometimes be mistaken for dry, flaky skin, whereas acute tinea pedis can often cause a painful, red, and blistering rash.

Athlete's foot is divided into three categories:

  • Chronic interdigital athlete’s foot (between the toes)
  • Chronic scaly athlete’s foot (largely on the soles)
  • Acute vesicular athlete’s foot (causing a blister-like infection)

Athlete's foot is easily spread in moist, unhygienic environments such as spas and locker room floors. It is typically treated with a topical antifungal.

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Ringworm (Tinea Corporis)

Ringworm (tinea corporis). CDC/Dr. Lucille K. Georg

Ringworm (tinea corporis) is a common fungal infection that is in no way related to worms. The rash is typically round and red with raised, flaky edges suggestive of a ring. It can appear anywhere on the body but is mostly seen on arms and legs. A related fungal condition, called tinea capitis, involves the scalp, head, and face (particularly around hair follicles).

Ringworm is highly contagious and easily spread through skin-to-skin contact with a lesion. It can also be passed by touching contaminated surfaces or objects such as combs, pool surfaces, towels, doorknobs, bedding, showers, or pets.

Ringworm can be effectively treated with oral or topical antifungal medications.

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Chronic Psoriasis Plaque

Chronic psoriasis plaque. iStockphoto.com/Tina Lorien

Psoriasis is an immune-related skin disorder characterized by a scaly rash, most commonly n on the front of the elbows and knees (called the extensor surface) as well as the scalp. It can be triggered by stress, medication, infection, skin injury, and even environmental factors like the sun. 

The rash typically consists of thick, silvery plaques over a reddened base of skin. The borders of the plaque are usually distinct and can sometimes mimic ringworm.The scales are often very loose and can bleed when scratched.

Chronic plaque psoriasis is the most common form of psoriasis, affecting around five percent of the population. Other types include pustular psoriasis (causing pus-filled lesions) and guttate psoriasis found in children.

Treatment varies by the type and severity of an outbreak and can include such options as topical creams, drugs, and UV light therapy.

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Scabies (Sarcoptic Mange)

Scabies (sarcoptic mange). Centers for Disease Control and Prevention

Scabies (sarcoptic mange) is a contagious, intensely itchy skin condition caused by a tiny mite that burrows beneath the skin. LIke head lice, it can spread quickly through schools and nursing homes and is easily passed between family members.

Scabies mimics other skin conditions such as dermatitishot tub folliculitis, and pityriasis rosea. To make the diagnosis, a doctor will need to scrape a portion of the rash and look at it under a microscope for evidence of infestation. Treatment involves the use 5% permethrin cream or lotion in association with oral histamines or topical steroids to treat the rash.

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Pityriasis Rosea

Pityriasis rosea. Centers for Disease Control and Prevention

Pityriasis rosea is a common, benign rash that tends to resolve on its own without treatment. In many cases, it will begin with what we call a "herald patch," a single round lesion which appears most frequently on the trunk.

Pityriasis rosea can often look like ringworm at first, but, over the course of days or weeks, manifest with the appearance of smaller lesions on the trunk, legs, or arms.The rash is rarely seen on the face, except occasionally in children.

Pityriasis rosea is not well understood and is believed to be caused by a virus. While treatment is typically not indicated. a topical steroid or antihistamine may be used the rash is itchy.

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Herpes Simplex

Herpes simplex. CDC/Dr. M.F. Rein and Susan Lindsley

Herpes simplex is a viral infection characterized by the formation of painful, open ulcers. The lesion can be caused by either HSV type 1 (resulting in cold sores) or HSV type 2 (which causes genital herpes). Herpes is most readily transmitted by direct contact with either a sore or the body fluid of an infected individual, although infection can occur even when there are no visible signs of infection.

When symptoms do appear, they initially present with tingling and redness, followed by the formation of blister-like lesions which rapidly merge into an open, weeping sore. The sores can sometimes be incredibly painful and are often accompanied by a fever and swollen lymph glands. Treatment involves the use of antiviral drugs such acyclovir or valacyclovir.

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