Analysis of Rash

Analysis of Rash



1. How long have you had the rash? (To determine if acute or chronic.)

2. Where is the rash and where did it start?

3. Contact with anyone that also has had a rash? ( e.g. may suggest scabies, chicken
pox, impetigo, meningococcal disease.)

4. Past history of skin disorders? (e.g. atopic dermatitis (eczema), hives, scabies,
dermatitis herpetiformis, asteatosis (dry skin).)

5. Have you worn any new clothing recently? (e.g. contact dermatitis.)

6. Have you used any new cosmetic products recently? (e.g. perfumes, hair sprays
etc may cause allergic contact dermatitis.)

7. Do you have an allergic tendency? (e.g. asthma, hayfever - increases the chance of
atopic dermatitis (eczema).)

8. Aggravating factors? (e.g. eczema may be aggravated by soap, frequent washing,
chlorinated water, bubbles baths, sweating (because it is drying), sand pits, winter months,
extremes of hot and cold weather, emotional stress, wool clothing or blankets, chemical
disinfectants, detergents, scratching or rubbing, pregnancy, menstruation and various food
stuffs.)

9. Past medical history? ( e.g. Celiac disease may be associated with dermatitis
herpetiformis; presence of other allergic type conditions such as asthma, hives and hay fever
increase the risk of atopic dermatitis; varicose veins may suggest varicose eczema (patches
of dry scaly skin that overlie leg varicose veins); Erythema nodosum may be associated with
sarcoidosis, inflammatory bowel disorders (Crohn's disease and ulcerative colitis) and some
infections (streptococcal, tuberculosis, leprosy and fungal infections); necrobiosis lipoidica is
often associated with diabetes mellitus.)

10. Medications? (Some medications may cause sensitivities such as aspirin, morphine and
codeine.)

11. Known allergies? (e.g. food allergies, insect allergies, drug allergy.)

12. Family history? (e.g. allergies, psoriasis, eczema.)

13. Occupational history? (e.g. exposure to fiberglass may cause a generalized sensitivity;
allergic contact dermatitis e.g. contact with resins, rubber, latex, dyes.)



Analysis of related symptoms

1. Fever? (May suggest chicken pox, serum sickness, eczema herpeticum, exfoliative
dermatitis, severe allergic contact dermatitis from poison ivy.)

2. Itch, and if so is the itch mild, moderate or severe? (e.g. a very itchy rash may
suggest hives, atopic dermatitis, scabies, skin lice, insect bites, chicken pox, dermatitis
herpetiformis; a mild to moderate itchy rash may suggest tinea, psoriasis, drug eruption,
pityriasis rosea, candida or lichen simplex.)

3. Nails affected? (May suggest psoriasis or tinea.)

4. Butterfly shaped facial rash? (Suggests systemic lupus erythematosus.)

5. Symptoms of atopic dermatitis (eczema)? (e.g. itchy, red, dry, scaling, cracked skin.
The typical distribution changes as the person grows older. In infants the rash is usually on
the cheeks of the face, the folds of the neck and scalp. It may then spread to the limbs and
groin. During childhood a drier ad thicker rash develops in front of the elbow, behind the
knees and on the hands and feet, which may be dry, itchy, cracked and painful. Rarely does
eczema have an adult onset.)

6. Symptoms of allergic contact dermatitis? (e.g. may range from faint redness to
severe swelling, symptoms are often worse in area around the eyes, genitals and on hairy
skin, symptoms are least on hairless skin such as palms and soles. Allergic contact
dermatitis is usually confined to the site of exposure to the allergen.)

7. Symptoms of psoriasis? ( e.g. red lesions that enlarge and develop a silvery scale. The
commonest sites are the backs of the elbows and knees, then the scalp, sacral areas,
genital and nails.)

8. Symptoms of meningococcal septicemia? ( e.g. may start with cough, headache,
sore throat, nausea, vomiting and then progress to spiking fevers, chills, aching joints and
muscles. Later drowsiness, hemorrhagic rash most commonly on trunk and extremities but
can be anywhere, and low blood pressure. May have stiff neck and dislike for light.)

9. Symptoms of lupus erythematosus? ( e.g. fever, malaise, tiredness, Raynaud's
syndrome, butterfly shaped facial rash. Systemic lupus erythematosus may be complicated
by protein in the urine.)

10. Symptoms of Rosacea? ( e.g. flushing of the face with increases in skin temperature,
acne-like rash over the face. May be complicated by blepharitis, conjunctivitis, episcleritis or
corneal ulcers.)

11. Symptoms of sarcoidosis? (e.g. shortness of breath, cough, tiredness, skin symptoms
occur in 10% of cases and may include purple or brown plaques or nodules on face, nose,
ears and neck in chronic sarcoidosis.)

12. Symptoms of dermatomyositis? ( e.g. muscle weakness, muscle tenderness, muscle
pain, purple colored rash on face (especially on the eyelids, upper cheeks and forehead),
swelling round the eyes, red rashes, pain in joints, Raynaud's phenomenon, difficulty
swallowing, fever, weight loss, tiredness.)