Rash - Widespread and Cause Unknown

Symptoms

DEFINITION

• Rash over most of the body (widespread or generalized)
• Occasionally just on hands, feet, and buttocks - but symmetrical
• Small spots, large spots, or solid red
• Cause of rash is unknown

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General Information

• Three widespread rashes that individuals may be able to recognize are: hives, insect bites, and sunburn. If present, use that topic. If not, use this topic.
• An adult with fever and rash should seek medical attention immediately. A number of serious infections present in this manner.

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See More Appropriate Topic (instead of this one) If

• You have HIVES
• The rash is from INSECT BITES
• You have a SUNBURN

Should I Call?

WHEN TO CALL YOUR DOCTOR

Call 911 Now (you may need an ambulance) If

• Very weak (can't stand)
• Purple or blood-colored rash with fever
• Sudden onset of rash (within past 2 hours) and also have difficulty with breathing or swallowing
• Difficult to awaken or acting confused
• Life-threatening reaction (anaphylaxis) in the past to similar substance (e.g., food, insect bite/sting, chemical, etc.) and less than 2 hours since exposure

Call Your Doctor Now (night or day) If

• You feel weak or very sick
• Purple or blood-colored rash without fever
• Bright red skin that peels off in sheets
• Bright red, sunburn-like rash after either wound infection or recent surgery
• Bright red, sunburn-like rash after either tampon use or nasal packing
• Rash looks like large or small blisters (i.e. fluid-filled bubbles or sacs on the skin)
• Rash began within 4 hours of a new prescription medication
• Fever
• Headache
• Stiff neck (unable to touch chin to chest)
• Joint pain or swelling
• Sores also present in mouth

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If

• A widespread rash, but none of the symptoms described above

Care at Home

HOME CARE ADVICE FOR WIDESPREAD RASHES (Pending Talking With Your Doctor)

1. Reassurance: There are many causes of widespread rashes and most of the time they are not serious. Common causes include viral illness (e.g., cold viruses) and allergic reactions (to a food, medicine, or environmental exposure).
2. For Non-Itchy Rashes: No treatment is necessary, except for heat rashes, which respond to cool baths.
3. For Itchy Rashes:
   • Wash the skin once with gentle non-perfumed soap to remove any irritants. Rince the soap off thoroughly.
   • You may also take an oatmeal (Aveeno) bath or take an anithistamine medication by mouth to help reduce the itching.
4. Oatmeal Aveeno Bath for Itching: Sprinkle contents of one Aveeno packet under running faucet with comfortably warm water. Bathe for 15 - 20 minutes, 1-2 times daily. Pat dry with a towel - do not rub.
5. Oral Antihistamine Medication for Itching: Take an antihistamine like diphenhydramine (Benadryl) for widespread rashes that itch. The adult dosage of Benadryl is 25-50 mg by mouth 4 times daily.
   • Do not take antihistamine medications if you have prostate enlargement.
   • Antihistamines may cause sleepiness. Do not drink, drive or operate dangerous machinery while taking antihistamines.
   • An over-the-counter antihistamine that causes less sleepiness is loratadine (e.g., Alavert or Claritin).
   • Read the package instructions thoroughly on all medications that you take
6. Contagiousness: Avoid contact with pregnant women until a diagnosis is made. Most viral rashes are contagious (especially if a fever is present). You can return to work or school after the rash is gone or when your doctor says it is safe to return with the rash.
7. Expected Course: Most viral rashes disappear within 48 hours.
8. Call Your Doctor If:
   • You become worse

And remember, contact your doctor if you develop any of the "Call Your Doctor" symptoms.

Photo Example

Rocky Mountain Spotted Fever

This photo shows the lower legs of a patient with the the typical rash of Rocky Mountain Spotted Fever.

There is a wide spread red rash (red spots). There are also some petechiae (very small red-purple spots that don't blanch when you push on them).

Chickenpox Rash

Chickenpox is an infectious disease caused by the varicella-zoster virus resulting in an itchy blister-like rash, tiredness and fever.

It appears first on the trunk and face, but can spread over the entire body causing between 250 and 500 itchy blisters.

Source: Wikimedia Commons, Permission is granted to copy, distribute and/or modify this document under the terms of the GNU Free Documentation License.

Chickenpox on Abdomen

The Chickenpox rash can occur on all body surfaces.

The rash is no longer contagious when all of the spots are crusted over and no new spots are appearing. This usually takes 7 days from the first appearance of the rash.

Penicillin Rash on the Arm

This patient had a widespread rash from an allergy to penicillin. The picture shows the arm.

Source: CDC PHIL, From the CDC's Public Health Image Library (http://phil.cdc.gov/), ID#1268, in the public domain. Content Provider(s): CDC / Dr. Sellers.

Scarlet Fever Rash

The photo shows the typical Scarlet Fever rash on the forearm.

The scarlet fever rash first appears as tiny red bumps on the chest and abdomen that may spread all over the body. Looking like a sunburn, it feels like a rough piece of sandpaper, and lasts about 2-5 days.

Scarlet fever is a disease caused by the same bacteria (Streptococcus) that causes strep throat. A person with Scarlet fever has a throat that is red and sore, usually a fever, usually swollen glands in the neck, and a Scarlet fever rash.

Source: CDC PHIL, From the CDC's Public Health Image Library (http://phil.cdc.gov/), ID#5163, in the public domain.