Simply stated, a rash is any change in the skin's normal condition, usually affecting the skin's color, appearance and texture. Numerous factors can cause rashes in people of all ages; they could result from contact with irritants, allergens or occur from an insect or animal bite. Infections, both bacterial and viral, are additional reasons why a rash may appear.
Contact Dermatitis
A large majority of contact dermatitis, approximately 80 percent, is caused by exposure to irritants such as soap, water, strong acids and solvents, according to "Conn's Current Therapy 2010." Allergens, such as chemicals, preservatives, metals, dust mites, pet dander and plant secretions, are capable of creating contact dermatitis by causing a hypersensitive skin reaction. A rash appears in response to the the irritants and allergens, sometimes extending beyond the immediate area where contact was made. Bope, Rakel and Kellerman note the skin usually improves with the use of topical or systemic steroids; steroid dosages should be tapered over a three-week period. Patient education includes teaching her to avoid the allergen so improvement can be seen.
Kawasaki Disease
Kawasaki disease is a rare childhood disease with an unknown cause, notes the National Heart Lung and Blood Institute Diseases and Conditions Index, or NHLBI, website. It is thought the body responds to a virus or infection with certain genetic factors causing the disease to manifest. In Kawasaki disease, the walls of the blood vessels become inflamed, causing redness as part of some symptoms. The child may have red eyes, lips, palms and soles. One of the main symptoms is a high fever that can last for at least 5 days, according to the NHLBI. A diffuse rash is noted as well as swelling in the hands and feet, and enlarged lymph nodes in the neck, according to the article by Lynn Schnautz and Patricia Leggett. Children with Kawasaki disease should be admitted to the hospital so that intravenous access can be initiated and proper cardiac monitoring started. Initial treatment includes the use of gamma globulin and aspirin to reduce inflammation and prevent blood clotting, according to Schnautz and Leggett.
Human Scabies
Scabies, a common skin infestation, erupts because of mites called Sarcoptes scabeiei invading the skin. According to Drs. Edward Bope and Robert Rakel, and Rick Kellerman, scabies is transmitted by direct contact with an infested person or contact with infested bedding and clothing. The incubation period is three weeks and re-infestation with symptoms may occur in one to three days. The rash associated with scabies appears as solid, raised firm lesions of varied color and size, some having distinct borders, and other lesions without, according to Bope, Rakel and Kellerman. Normally the head is spared in adults but can be affected in infants. Infestation on the soles and palms of infants' feet is common. Mite burrowing or observation of their eggs and feces may be evident on inspection. One popular treatment includes the use of 5% permethrin applied for 10 hours and repeated in a week, notes the same authors. Bedding and clothing will need to be decontaminated or removed from body contact for at least three days, so the mites can die.
References
- "Conn's Current Therapy 2010"; Edward Bope, MD, Robert Rakel, MD, and Rick Kellerman; 2009
- National Heart and Blood Institute Diseases and Conditions Index: Kawasaki Disease
- "Critical Care Nursing Clinics of North America" Kawasaki Disease: A Ride for Little Girls Too!; Lynn Schnautz and Patricia Leggett; 2008
