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How Do You Know If a Rash Is Serious?

Rashes are usually not life-threatening. Seek immediate medical attention, however, when the rash is all over the body, it's accompanied by fever, it appears suddenly and spreads quickly, it starts to blister or turns into open sores, it's painful, or it's infected.
Rashes are usually not life-threatening. Seek immediate medical attention, however, when the rash is all over the body, it's accompanied by fever, it appears suddenly and spreads quickly, it starts to blister or turns into open sores, it's painful, or it's infected. 

Skin rashes are abnormal changes in skin color, texture, or appearance and they may affect a localized area or occur all over the body. 

Most of the time, rashes are not life-threatening, but some rashes can be signs of more serious conditions. 

Symptoms of skin rashes depend on the condition. Some common symptoms of rash include: 

  • Bumps on the skin
  • Itching
  • Burning
  • Tingling feeling
  • Skin dryness
  • Redness
  • Blisters 
  • Open sores (ulcers)
  • Pain 

Call 911 or get to a hospital’s emergency department right away if you have a rash and any of the following symptoms: 

  • The rash is all over the body
  • Rash is accompanied by fever 
    • This could be a sign of infection or allergic reaction
  • The rash occurs suddenly and spreads quickly
    • This could a sign of an allergic reaction
    • If you have difficulty breathing along with the rash, call 911 or get to a hospital’s emergency department immediately
  • The rash starts to blister or turns into open sores
    • This may be a sign of an allergic reaction, a reaction to a medication, or an internal cause
    • This is especially a concern if a blistering rash affects the skin around the eyes, inside the mouth, or the genitals
  • The rash is painful
  • The rash is infected
    • Signs of infection include: 
      • Yellow or green fluid draining from the rash
      • Swelling
      • Crusting
      • Pain
      • Warmth in the area of the rash
      • Red streaks coming from the rash

What Causes a Rash?

The causes of skin rashes that may be signs of serious conditions vary. 

Some serious conditions that cause skin rashes include: 

How Is a Rash Diagnosed?

The cause of skin rashes is diagnosed with a history and physical examination of the skin. 

Tests may be used to determine the type of rash and/or the cause: 

What Is the Treatment for a Rash?

Treatment for skin rashes varies depending on the underlying condition that causes it. For many of the serious conditions that cause skin rashes, hospitalization may be needed. 

Treatment for rash caused by infection may include: 

Treatment for rash caused by an allergic reaction may include: 

  • Antihistamines
  • Topical creams
  • Biologics

Treatment for rash caused by pemphigus vulgaris may include:

  • Intravenous (IV) corticosteroids
  • Antibiotic creams and sterile bandages for blisters
  • Intravenous (IV) antibiotics to treat infection if it occurs
  • Mouthwashes and rinses with numbing medicine to relieve pain of blisters in the mouth

Treatment for rash caused by toxic epidermal necrolysis (TEN) is usually in an intensive care unit (ICU) or a specialized burn unit and may include:

  • Discontinuation of medications that may be causing the disease
  • Immunosuppressants
  • Wound care
  • Intravenous (IV) antibiotics to treat infection if it occurs
  • Plasmapheresis
  • Mouthwashes and rinses with numbing medicine to relieve pain of blisters in the mouth
  • Steroid and antibiotic eye drops or ointments 

Treatment for rash caused by drug rash with eosinophilia and systemic symptoms (DRESS syndrome) may include:

  • Stop the medication that is causing the reaction
  • Topical steroids 
  • Intravenous (IV) or oral steroids

Treatment for rash caused by toxic shock syndrome (TSS) may include:

  • The underlying source of infection (i.e., tampon, nasal packing, wound infection, or other source) must be identified and removed
  • Intravenous (IV) fluids
  • Intravenous (IV) antibiotics
  • Immunoglobulin
  • Blood pressure medicines 
  • Dialysis if the kidneys stop functioning
  • Surgery to remove dead tissue in severe case

Treatment for rash caused by meningococcemia may include:

  • Antibiotics
  • Surgery in cases where there is extensive tissue necrosis of the extremity

Treatment for rash caused by Rocky Mountain spotted fever may include:

  • The antibiotic doxycycline is used
  • The rash will go away when the underlying condition is treated

Treatment for rash caused by necrotizing fasciitis may include:

  • Surgery to remove dead and infected skin, fat, and muscle

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References
https://www.uptodate.com/contents/shingles-beyond-the-basics?search=shingles&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2

https://www.aad.org/public/everyday-care/itchy-skin/rash/rash-101

https://rarediseases.info.nih.gov/diseases/7355/pemphigus-vulgaris

https://emedicine.medscape.com/article/229698-overview

https://www.uptodate.com/contents/drug-reaction-with-eosinophilia-and-systemic-symptoms-dress https://www.nhs.uk/conditions/toxic-shock-syndrome/

https://rarediseases.org/rare-diseases/meningococcemia/

https://www.cdc.gov/rmsf/index.html

https://www.cdc.gov/groupastrep/diseases-public/necrotizing-fasciitis.html