Rashes

A “rash” is not an actual diagnosis. It is a term used to describe inflammation, change in color and/or texture of the skin. Some rashes are red and painful, others are scaly and itchy, and others have no symptoms at all. Rashes can be non-infectious (eczema, poison ivy, hives) or infectious (bacterial, fungal, viral, parasitic).

Non-Infectious

Some of the most common non-infectious rashes include allergic reactions, eczema, and psoriasis. Allergic reactions typically cause red itchy bumps or hives and can be a response to an allergen that is consumed or something that came in direct contact with the skin. Often patients are allergic to various ingredients in lotions, fragrance, laundry detergents and metals to name a few. While eliminating the allergen is the best way to avoid these rashes, there are topical treatments and oral allergy medications that alleviate symptoms and discomfort. Eczema and psoriasis are both chronic conditions that can be managed with topical and oral medications. See our specific pages on each condition to learn more.

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Infectious

One of the most common bacterial rashes is impetigo. This infection is frequently seen in children and causes red blisters that turn into sores with honey-colored crusting. Impetigo is typically easy to treat with topical antibiotics and occasionally oral antibiotics. A common viral rash seen in elderly persons and immunocompromised individuals is Shingles. This painful, red, blistering rash is caused by the Varicella Zoster Virus and is treated with oral antiviral medications. It is highly contagious and can cause significant discomfort so early detection and treatment are key. There are many types of commonly acquired fungal rashes. Tinea (ringworm and athletes foot), Seborrheic Dermatitis, Onychomycosis (nail fungus) and Intertrigo are a few. They can be flaky, red, itchy, or painful. Most are treated with topical washes and creams, however sometimes stubborn nail fungus or severe infections require oral medication.

Squamous Cell Carcinoma (SCC), the second most common form of skin cancer, is the result of abnormal cell growth arising from squamous cells in the outermost layer of skin. SCC often looks like scaly red patches, open sores, or wart-like growths that may crust or bleed. They can become disfiguring and sometimes deadly if left untreated.

Causes: Long term exposure to the sun’s ultraviolet (UV) rays over the course of a lifetime are the primary cause of SCC.

Risk Factors: People who have light skin, blond or red hair, and blue, green or gray eyes are all at higher risk for developing SCC. Individuals who have a history of prolonged or intense sun exposure are also at increased risk, including people whose occupations require long hours outdoors and those who spend a lot of time in the sun for recreational purposes. Anyone who has had a basal cell carcinoma is also at increased risk for SCC. Experts believe that people who use tanning beds are 2.5 times more likely to develop SCC.

Treatment Options: When detected and removed early, squamous cell carcinoma is almost always curable. The larger and deeper the tumor grows, the more disfiguring and potentially life threatening the carcinoma becomes. Treatment is almost always performed in an office setting with local anesthetic and very minimal discomfort afterwards. Surgery is the gold standard for treatment of SCC.

Mohs surgery is typically performed on areas that are cosmetically and/or functionally important (face, scalp, ears, hands, feet, genitals) and is done in stages to preserve as much healthy tissue as possible.

Excisional surgery is a surgical procedure that entails removal of the entire SCC and appropriate surrounding borders. The wound is then closed with stitches.

Electrodessication and Curretage (EDC) is a technique reserved for small SCCs. The provider scrapes off the SCC with a curette then burns the area to stop bleeding and destroy remaining cancer cells. This is typically repeated several times to ensure that there are no remaining cells.

Radiation therapy is used when a patient is not a candidate for surgery, or when they have lesions that are in difficult areas to treat with surgery. Radiation involves low energy X-Rays to destroy the tumor without cutting or anesthesia. Treatment are usually performed over the course of several weeks or daily for a month.

Basal Cell Carcinoma (BCC) is the most commonly occurring skin cancer, characterized by abnormally growing cells from the basal layer of the outermost layer of the skin. BCCs often look like open sores, red patches, pink growths, pearly bumps or scars, and can bleed or crust. If untreated it can be disfiguring, however it rarely spreads to other parts of the body and is not deadly.

Causes: cumulative long term exposure to ultraviolet (UV) rays is the main cause of BCC, which is almost always found on sun exposed areas.

Risk Factors: People with light skin, blonde or red hair, and blue, green or gray eyes are at higher risk for developing BCC. Individuals with prolonged or intense sun exposure, such as long hours of work or recreational activity outdoors, history of tanning bed use and blistering sunburns all increase the risk for BCC.

Treatment Options: Treatment is almost always performed in an office setting with local anesthetic and very minimal discomfort afterwards.

Mohs surgery is typically recommended for larger tumors that occur on areas that are cosmetically and/or functionally important (face, scalp, ears, hands, feet, genitals) and is done in stages to preserve as much healthy tissue as possible.

Excisional surgery is a surgical procedure that entails removal of the entire BCC and appropriate surrounding borders. The wound is then closed with stitches.

Electrodessication and Curretage (EDC) is a technique reserved for small or superficial BCCs. The provider scrapes off the SCC with a curette then burns the area to stop bleeding and destroy remaining cancer cells. This is typically repeated several times to ensure that there are no remaining cells.

Photodynamic Therapy (PDT) is FDA approved for the treatment of superficial BCC. A light sensitizing agent is applied to the lesion and then exposed to blue light, which activates the agent and subsequently destroys the affected tumor.

Topical Agents: Imiquimod and 5-Fluorouracil are both topical medications that are approved for treating superficial BCCs.

Prevention

Taking precautions to protect your skin from damaging UV rays is the most important step in preventing basal cell carcinoma. Below are some safety habits that should be part of your daily health care routine:

Avoid sun exposure at the hottest times of day, usually between 10am-4pm

Avoid sun burns

Never use tanning beds

Cover up with UV protective clothing, hat and sunglasses

Use broad spectrum (UVA/UVB) sunscreen with SPF 50, water-resistant when swimming or perspiration is expected. Apply 30 minutes prior to exposure and reapply every 2 hours for adequate protection

Examine your skin regularly for suspicious lesions

See your dermatologist yearly for a skin cancer screening