Rashes are a common, and often distressing, medical condition that could be harmless or could signify that something is seriously wrong. Because rashes have such a variety of meaning and are often vague, people are either overly cautious when they develop a rash or dismiss them as benign. I hope the following descriptions will help you distinguish between rashes that scream emergency room from those that whisper over-the-counter hydrocortisone cream.
We’ve all heard of meningitis and are aware that it can be deadly, so I’ll leave out the details here. There is a rash that sometimes accompanies meningitis that consists of many small purple or red spots likely on the trunk or legs that, when pressed, do not turn white. This is referred to as a petechial rash, and it is made of small bleeds from the blood vessels under the skin. If this rash appears with other signs of meningitis, rush to the ER immediately.
Another worrisome cause of rash is Lyme disease. Lyme disease is caused by tick bites, and people describe its appearance through the characteristic target-shaped skin rash. It begins as a large, flat red area that slowly spreads and the central area clears, giving it that target appearance. This might show up a few days to a few weeks after the initial tick bite, and many people don’t even recall the bite. If you find a target on your body, get yourself to the hospital. Other Lyme symptoms are flu-like and not specific, so the biggest clue is usually the rash.
While most people receive the MMR (measles, mumps and rubella) vaccine in early childhood, the increasing concern over whether the MMR vaccine causes autism (it doesn’t) has caused many parents to refuse vaccines for their children. As a result, measles is making a comeback. Measles can be deadly, but more commonly it causes complications ranging from diarrhea to encephalitis. There are really two distinct rashes associated with measles. One is Koplik’s spots, red bumps with white centers in the mouth of an infected individual, which often disappear after a day or two and are often not seen by a physician. The other rash is the typical rash that spreads from the head down and consists of small, flat red areas covered with small bumps. If you haven’t been vaccinated, I strongly recommend it.
The herpes rash consists of painful fluid-filled blisters that burst and crust over into ulcers, which can occur on your lips and genitals. It is caused by two viral strains, HSV-1 and HSV-2, and those with either strain are chronically infected. Oral sores are referred to as cold sores or fever blisters and are caused by HSV-1, which affects about 80 percent of Americans. Genital lesions, which were formerly exclusively HSV-2, are now equally caused by both strains secondary to the rise in oral sex. About 25 to 30 percent of Americans are affected by genital herpes. These viruses can also cause infection on the fingers, called herpes whitlow, or on the eyes, called ocular herpes. Herpes Gladiatorium can be transmitted from contact sports like wrestling and rugby. While there is no cure for herpes infections, recurrences can be treated with anti-viral agents — like valacyclovir or acyclovir — prescribed by your doctor.
Another chronic skin condition is psoriasis. Psoriasis causes red scaly plaques, which are often itchy, to form on the skin in the setting of inflammation and local excess skin production. The excess skin often causes the plaques to take on a silvery-white appearance. Psoriasis can occur on any part of the body and can be isolated to one or a few areas or can affect the entire body. The rash can be very distressing; some even compare it to other chronic illnesses such as depression. However, treatment is available through a dermatologist and can range from topical creams to phototherapy to systemic oral agents.
If you’ve ever been curious why shower shoes for dorm living are so widely encouraged, look no further than your friendly athlete’s foot. This is a red, scaly, intensely itchy rash of the feet, along with a strong odor, that usually begins between toes and can spread to other parts of the foot. Treatment usually involves over-the-counter medications. Other ways to prevent and treat athlete’s foot include wearing cotton socks, “airing out” the feet by wearing sandals and thoroughly drying your feet after you shower. It’s called athlete’s foot because it’s very common in athletes who sweat almost daily in usually the same pair of shoes with thick socks, trapping moisture close to the skin and allowing the fungus to develop into a rash. It’s not as contagious from the shower floor as commonly believed, but I still think shower shoes are a good idea.
Finally, there are warts — common, rough bumps that can occur anywhere on the body but are common on the hands and feet. They are caused by infection with human papillomavirus, the same family of diseases that include the strains that cause genital warts and cervical cancer. The strains that cause warts are different from those that cause cancer, and you will not develop cancer from a wart. Similarly, Gardasil will not protect you from developing warts on your hands and feet. Warts are benign skin lesions that are usually asymptomatic unless they are located in a position that is often used, such as the soles of the feet or palms of the hand. They do clear on their own, but it can take a few years. Treatments include over-the-counter topical medications containing salicylic acid or cryotherapy, where a wart is frozen using liquid nitrogen. Many doctors, however, say the best treatment for warts is duct tape (yes, the shiny silver stuff college students use to keep their lives together): Just take a small piece and place it over the wart, replace as necessary until the wart is gone.
These are just some of the rashes that you might find, and the information is by no means a substitute for seeking medical attention if you are concerned about a rash on your body.
Katie is a University Medical student. She can be reached at k.mcbeth@cavalierdaily.com.
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