Rashes

Rashes are a reflection of the body’s way of telling you that something is wrong. Common causes of rashes are allergies to topical or environmental allergens, viruses, poison ivy, or as side effects of oral medications. If a rash is persistent or accompanied by a fever, it’s important to come in for an exam at our New York practice. Determining the correct diagnosis for any rash on your body is part of proper skin care, to ensure an accurate diagnosis so the right course of treatment can be determined.

If you’re ready to learn more about rash treatment and prevention as part of your skin care routine, please don’t hesitate to contact us online today or call 212-535-3088. Dr. Michele S. Green, a board certified NYC dermatologist, practices the latest techniques at the forefront of skin care restore the health that you deserve.

Poison Ivy
Poison Ivy, oak, or sumac can develop a pruritic red itchy rash that often blisters. The rash is caused by the urushiol oil found in the plants. The itchy, blistering rash often begins 12 to 72 hours after one comes into contact with the oil.

The rash is not contagious to another person. When the rash seems to spread, this is often caused by a delayed sensitivity reaction. You can spread the oil on your skin after direct exposure by touching other parts of your body. Urushiol can stick to almost anything including pet’s fur, gardening tools or clothing. It is important to clean all surfaces and objects that may have the oil on it.

Topical and oral steroids as well are effective in treating poison ivy. Oatmeal baths, topical emollients, and antihistamines can lessen the symptoms as well. You can also prevent a poison ivy rash in the first place if you wash skin immediately with lukewarm water and soak if you suspect exposure to the plant. Wash all clothing or objects that may have been exposed to urushiol oil.

Pityriasis Rosea
Pityriasis rosea is a skin rash that is often preceded by an upper respiratory tract infection. The first sign is often a “herald” patch, which is a single 2- to 10-cm oval red patch that typically appears on the abdomen. Often several days after the original patch, multiple smaller red scaly oval-shaped patches appear on the trunk and sometimes on the extremities. The distribution on the back has been called a “Christmas-tree” distribution because of its characteristic outline.

The initial rash may be asymptomatic or accompanied by intense itching. At times the rash may be accompanies by low-grade fever, nausea, headache, and fatigue.

The cause of pityriasis rosea is believed to be viral. No treatment is required. Oral antihistamines and topical emollients and steroids can provide relief from the pruritus. Direct sunlight has also been shown to hasten the resolution of the rash.

Eczema
Eczema is a general term for an inflammation of the skin (dermatitis). The most common type of eczema is the form called atopic dermatitis. Atopic dermatitis is usually associated with a group of diseases that are often inherited, such as asthma and hay fever.

Eczema affects about 10 to 20 percent of infants and about three percent of adults and children in the United States. Some children outgrow eczema. For others, it is a chronic condition that continues throughout adult life.

The main symptom of eczema is pruritus or itchy skin. There are times, when a patient’s first symptom is itching with almost no obvious rash. Classic locations on the body for eczema are the face, back of ears, back of the knees, wrists, hands, or feet. Generally you will see red scaly patches that can crust, turn brown and either become hyper-pigmented or hypo-pigmented as the eczema heals.

The precise cause of eczema is unknown, but it is believed to be linked to an overactive response by the body’s immune system to an irritant. It is this response that causes the symptoms of eczema. Some forms of eczema can be triggered by substances that come in contact with the skin, such as soaps, cosmetics, clothing, detergents, jewelry, or sweat. Stress and changes of temperature or humidity can also worsen eczema.

There are different types of eczema ranging from atopic dermatitis, which is usually genetic and starts in childhood, to contact dermatitis, which is typically a reaction to an irritant such as nickel or poison ivy. Other forms of eczema are nummular eczema that occurs in round coin-shaped areas, and dyshidrotic eczema that appears predominantly on the hands and feet in the form of vesicles.

Dr. Green will evaluate your medical history, physical exam, and family history. A biopsy of the skin or skin allergy testing may be advised to make the correct diagnosis.

Treatment for eczema is a combination of preventing itching, inflammation and worsening of the condition. Topical emollients, steroid creams, and oral antihistamines may be prescribed. Taking oatmeal baths and avoiding hot showers typically help this condition. Lifestyle modifications to avoid triggers for the condition are also recommended by Dr. Green.

Lichen Planus
Lichen Planus is a rash that can develop on the skin, tongue, scalp, and oral mucosa. The typical rash of lichen planus has been described as the “5Ps”: pruritic, planar, purple, polygonal papules. The rash is common around the wrist and ankles and persists for weeks, often turning blue-black or dark brown in discolored patched on the skin.

The eruption may appear as papules, pruritic bumps, blisters, or rarely as erosive sores particularly in mucous membrane areas. The nails may be affected with ridging or grooves on the nails, with splitting or thinning or even loss of nails. The scalp may be affected with redness, irritation, and patchy hair loss or even scarring.

Lichen planus is most common in middle-aged adults. More women get lichen planus in their mouths than men. Lichen planus is believed to be an autoimmune disease. Some cases of lichen planus can be a complication of hepatitis C virus infection.

Various medications are used to treat lichen planus including oral and topical steroids, retinoids, tacrolimus ointment, antihistamines, and PUVA. Many cases of lichen planus resolve within two years. Dr. Green can prescribe lightening agents or laser therapy for the dark spots that sometimes remain after treatment.

If you’ve noticed a persistent or unusual rash on your skin, a prompt diagnosis followed by the right treatment can help. Contact us online today or call 212-535-3088 to learn more about our individualized approach to skin care.