Skin rashes (or skin rash ) are perhaps one of the most frequent symptoms one has to deal with throughout one’s life. The skin, in fact, is the organ that covers our organism and, given its exposure, any alteration or imperfection in it will be immediately visible and evident to the subject but also to all the people with whom one relates.
Therefore, regardless of the clinical significance of the skin manifestation, an alteration of the skin can cause a state of discomfort, shame, malaise and lead the affected person to even social isolation.
Being the most superficial organ of our body, the skin is often subject to injuries or alterations caused both by external agents (wounds, burns, bites, bacterial infections), and by internal causes, as in the case of disorders related to the immune system that lead to the development of autoimmune diseases or prolonged stressful conditions that significantly reduce the immune defenses.
The skin is subject to two types of eruptions :

  • primary (or elementary ) lesions defined as lesions that arise on healthy skin, ie on a portion of skin not previously affected by pathological manifestations and alterations;
  • secondary lesions, which are those that affect portions of skin already affected by pathological processes; they are therefore the consequence of primitive lesions.

Let’s see in more detail which manifestations characterize the two types of lesions, and for each which are the most common forms.

Spots on the skin Spots
are alterations limited to a more or less limited area that cause a change in color compared to the adjacent areas of the skin.
This chromatic alteration may be due to:

  • Quantitative alterations of melanin (natural pigment whose quantity determines the color of the skin, hair and hair). When there is an increase in its quantity, there is a condition of hyperchromia (characteristic of nevi and melanomas). On the contrary, its decrease leads to a condition of hypochromia, characteristic of vitiligo;
  • Alterations to blood vessels , as in the case of some types of malformations of the vessels or in cases of extravasation of blood from the capillary bed. The staining of the spots in this type of event is characterized by a red aspect tending to purple;
  • Alterations in the amount of pigments due to the presence of substances that have reached the spot through the bloodstream (as in the case of xanthochromia, a frequent condition in diabetic subjects who show a yellowish color in the soles of the feet and on the palms of the hands), or that come locally from external sources, as in the case of tattoos.

I have explored for you the problem of red spots or small red dots on the skin and was examined in a specific article that I invite you to read by clicking here .

The papules
The papule appears as a well-defined and circumscribed relief of the skin, the dimensions of which vary according to the case, but generally extend over an area of ​​less than half a centimeter in diameter. If more adjacent papules join together, there is the formation of lesions which are called plaques. The main skin affections characterized by papules include: warts, acne, senile keratosis, lichen planus, molluscum contagiosum.
These rashes can be classified as follows:

  • Epidermal papules , typical of condylomas and warts, which manifest themselves as a thickening of the skin;
  • Dermal papules , typical of granulomas, in which there is inflammation at the level of the most superficial layer of the skin.

Both types of papules are a risk factor for the onset of melanomas.
Among the pathologies that have papules as their characteristic symptom we have:

  • condyloma acuminata : it is a typical skin rash of viral origin that is localized in the genital and anal area and is transmitted through unprotected sexual intercourse;
  • molluscum contagiosum : another infection of viral origin that typically affects children under the age of 5. It appears as a small swelling that is localized on the face, at the level of the trunk, armpits and genitals. Contagion can occur by frequenting places that are not perfectly sanitized and humid such as swimming pools.
  • lichen ruber planus : it is a skin disease
  • warts : warts are always skin formations of viral origin that are located on the hands and feet. The transmission of this virus is favored by the reduction of the integrity of the skin.

Nodule (or node)
The nodule is a lesion that appears well delimited, of a solid consistency and that can be located either in a superficial layer of the skin (dermis) or in a deeper site (hypodermis). The differential diagnosis with the previous lesion (papule) is easy due to its size, which is more than half a centimeter in diameter.
This type of injury can be the result of the accumulation of substances ( uric acids as in the case of gout), or the development of a neoplasm (melanoma, lipoma), or even a state of inflammation.
The pathologies that are characterized by the presence of such skin rashes are:

  • rhinophyma : it is a hypertrophic process affecting the nasal mucosa;
  • erythema nodosum : it is characterized by the formation of nodular structures of red color and warm to the touch that are localized at the level of the legs, tibial crest, forearms and buttocks;
  • scars : ciactric women who have a hypertrophic tendency can lead to the formation of skin nodules;
  • keloid : this is a nodular formation with a pinkish appearance that can sometimes cause itching;
  • Dupuytren’s disease : This is a condition caused by the formation of nodular structures located in the area of ​​the palm of the hands at the base of the fingers.

The scales
The scales are elementary skin lesions that are characterized by the presence of a lamina formed by corneocytes (the most superficial skin cells) which tend to detach.
They are classified into:

  • foliacea, large in size similar to leaves;
  • lamellar, large and thick;
  • furfuracea reminiscent of dandruff.

They are typical of:

  • seborrheic dermatitis ;
  • psoriasis;
  • ittiosi;
  • athlete’s foot.

Erythema Erythema is
one of the most frequent causes of skin rash , it is a redness that can be more or less limited to a limited area. The nature of this manifestation is vascular, in which if there is an increase in blood flow of arterial interest there is a bright red erythema (a frequent condition in solar erythema), if instead there is an increase in capillary blood flow , the coloration of the erythema changes from red to purplish / blue.
There are different types of erythema:

  • buttock;
  • passive;
  • nodoso;
  • by photosensitization;
  • sudamina.

Given the variety of types of these widespread rashes, it is advisable to contact a dermatologist for a correct diagnosis.

Vesicles or bubbles
The vesicle or bubble appears as a well-localized and circumscribed collection of small liquid (usually less than half a centimeter).
Blisters are classified according to the layer of the skin in which they form and are identified as:

  • Intraepidermal vesicles (located in the epidermis) in which viral forms are differentiated, due to the accumulation of fluid containing the Herpes virus and forms due to inflammatory processes such as dermatitis;
  • Subepidermal vesicles (located deeper), are found in the case of autoimmune diseases in which there is an accumulation of antibodies, immunoglobulins (type A species) and proteins.

These rashes are characteristic of the following pathologies:

  • varicella;
  • pemphigus , a rather rare pathology that manifests itself with the presence of bullous lesions in the oral mucosa;
  • hand-foot-mouth whose causative agent is the Coxsackie virus which typically affects children and infants.
  • herpes zoster;
  • atopic and contact eczema.

The pustule is a limited, swollen collection that collects pus. In most cases they are formed as a result of an infectious process and have a rich content of immune system cells called neutrophils, but in a small percentage of cases their formation is linked to non-infectious but autoimmune events, as in the case of psoriasis .
Often this type of eruption results in the appearance of scars, therefore permanent signs as in the case of chickenpox.
Pustules are typical skin rashes of:

  • acne;
  • boils;
  • atopic dermatitis;
  • rosacea;
  • impetigo.

This type of rash is characterized by the onset of severe itching and to arise as a result of allergic phenomena due to insect bites or contact with substances called allergens.
The manifestation is first of all a bright red color due to the vasodilation that is created, and subsequently due to the liquids that are localized on contact, the wheal takes on a pale color.
A wheal is a type of rash that accompanies edema that is the result of fluid leaking from blood vessels.

Rashes characterized by edema or wheals are:

  • hives , which occurs with the appearance of wheals which usually subside in 2-4 hours.
  • inflammatory edema;
  • venous edema;
  • lymphatic edema;
  • edema following a trauma.

Rashes accompanied by fever Rashes of this type
are characterized by the appearance of an eruptive fever that manifests itself with the appearance of bubbles of various shapes and characteristics. The diseases in question are called “exanthematics” where the rash represents a red rash.
The diseases in question are:

  • measles;
  • rubella;
  • fourth disease;
  • fifth disease;
  • scarlet fever.

Let us now analyze what may be the main causes of the appearance of these rashes , emphasizing right now that, since it is a symptom that can hide serious and potentially serious pathologies, the diagnosis must necessarily be made by a specialist doctor.

What are the main causes of rashes
The rashes are due to causes of different nature that we can mainly distinguish in: autoimmune, inflammatory, contact with allergens, bacterial, parasitic and viral.
Let’s see them in detail.
Among the diseases that affect the immune system (autoimmune) and that give manifestations to the skin we have Systemic Lupus Erythematosus (SLE), in which the affected subjects, often at a young age, have a red color on the face with a characteristic butterfly shape. But skin manifestations are also frequent in cases of rheumatoid arthritis and diabetes.
Among the inflammatory causes are identified all those manifestations of an allergic or irritative nature that result in dermatitis, eczema, urticaria, folliculitis and psoriasis.
The bacterial forms are mainly due to colonization by streptococcus and staphylococcus; while the parasitic ones are linked to the infestation of mites that cause scabies, toxoplasmosis, and candida.
TheSkin rashes can largely be caused by viruses, and among these we recognize exanthematous diseases, the typical infectious diseases of children: measles, chicken pox, scarlet fever and rubella. The HIV virus that causes AIDS leads the subject to a state of immunodeficiency and possible development of Kaposi’s sarcoma which manifests red patches on the skin.
Acne mainly affects the younger population, especially in adolescence and puberty, and is the synergistic manifestation of an inflammatory process and an infectious process. In fact, there is an accumulation of sebum due to an increase in hormonal levels, which leads to less oxygenation of the skin and an accumulation of bacteria in the hair follicle. These factors lead to a state of inflammation characterized by pustules containing pus and which can leave a scar.

How to diagnose them

Beyond the most common skin manifestations that resolve in a short time (such as acne pustules), the diagnosis in order to identify the triggering cause of these skin alterations must be entrusted to the careful observation of the referring physician. which will give indications on whether to undergo further tests by contacting a doctor who specializes in dermatology.

What therapies are available?
The correct therapy for skin rashes must only be entrusted to a dermatology specialist who, based on the amnestic data collected, on the observation of the lesions and on specific diagnostic tests, is able to identify the cause triggering the problem.
The specialist is the only professional figure able to determine the right therapeutic strategy suited to the individual case, without worsening the problem or incurring other side effects. Therefore, he is wary of resorting to improvised therapies or do-it-yourself by getting news on the internet.
The therapies available today are numerous and very specific. A first indication provided, in case of mild pathologies, is generally linked to recommendations on correct habits for adequate skin hygiene and on a diet rich in vitamin E and vitamin C which have an antioxidant effect.
The therapies available are pharmacological in nature, administered in the form of ointments, creams and soothing agents containing mainly drugsanti-inflammatory corticosteroids, antifungals, antibiotics and in the case of subjects who develop skin rashes from allergic reactions, antihistamines.
In addition to drug therapies, there are also instrumental techniques available, including:

  • Laser therapy : effective especially on small lesions of an acneic nature or with scarring;
  • Phototherapy : this technique exploits the action of UVB rays and is used in case of dermatitis and psoriasis. This type of rays in the long term can give very important side effects, therefore its use must only be prescribed by a specialist doctor.

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