Case 21 a rash of rashes

It usually happens as a result of the inflammation of the skin, wherein the color and texture of the skin changes and red bumps are formed. These red bumps are itchy, irritating and painful as well. Usually, a skin allergy causes the development of rashes, which if, not treated timely, can turn into a life-threatening infection. There are many types of skin rashes.

Case 21 a rash of rashes

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Once a person has been sensitized to an offending substance, further exposure may result in relatively rapid development of local inflammation with erythema, papule formation, induration, and weeping vesiculation. Inflammation usually begins about 12 hours after exposure; intensity peaks in 50 hours or more.

The rash may spread locally around the margins of the original site or to distant sites that did not have contact with the allergen.

Potentially, the entire skin surface could become involved a condition known as erythroderma or exfoliative dermatitis. Allergic contact dermatitis results from a true allergic i. Cross-reactivity with antigenically similar substances may occur.


Initially, during the refractory period, the patient may be exposed without developing a reaction. During the induction phase, which may last from 4 days to several weeks usually about 14 to 21 daysthe development of complete allergic sensitization occurs as the allergen comes in contact with the skin.

After the skin is fully sensitized, further contact with the allergen may result in rapid and severe dermal manifestations. When no further contact with the allergen occurs, the patient is in the period of persistence of sensitivity.

Case 21 a rash of rashes

The level of sensitivity can decrease over time, but sensitization may be lifelong. Most allergens that cause allergic contact dermatitis have molecular weights of less than daltons.

The allergens are haptens rather than complete antigens; they must penetrate the skin and combine with endogenous proteins to form full antigens.

Langerhans cells play a key role in then presenting the antigen to T lymphocytes, thereby activating the T cells. The sensitized T cells proliferate in the paracortical regions of the lymph nodes and produce effector and memory lymphocytes that remain in the general circulation.

On subsequent contact with the complete antigen, the effector cells release lymphokines that may result in rapid and severe, local inflammation. Many factors can affect the development of allergic contact dermatitis, including characteristics of the allergen itself, patient factors, and environmental conditions.

Allergen factors include the physiochemical nature of the allergen e. Page Share Cite Suggested Citation: Skin Lesions and Environmental Exposures: Integrating a Missing Element into Medical Education. The National Academies Press. In addition, age and genetic predisposition can influence the development of allergic contact dermatitis.

Persons who have histories of atopic dermatitis have been reported to have decreased risk of developing allergic dermatitis but increased risk of developing irritant dermatitis.

Common predisposing environmental factors for allergic contact dermatitis are pressure, friction, heat, and prolonged immersion in water such as occurs during wet work.

Relative humidity, ambient temperature, and season of the year also play roles in development of allergic contact dermatitis. Only several hundred of the thousands of chemicals used are known to cause allergic contact dermatitis.

With the exception of nickel, cobalt, and some forms of chromium, most metals do not produce sensitization.

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Strong inorganic alkalies and acids seldom cause allergic reactions. Aromatic compounds with polar or ionic substituents are typically sensitizing agents e.

In addition, chemicals that are structurally similar to the original sensitizing agent may provoke recall of the specifically sensitized lymphocytes, a phenomenon known as cross-sensitization.

For example, persons exposed to p-phenylenediamines used in the rubber industry may react to related substances used in photographic developers and dyes. Persons sensitized to Rhus plants such as poison ivy or poison oak may be sensitive to cross-reacting substances found in exotic trees and their derivative products lacquers, varnishes, and oils.

Some chemical groups known to cause allergic contact dermatitis Aromatic amines.Nov 21,  · The rash is described by prisoners as bright red pimple-like bumps with occasional pockets of pus on thighs, buttocks, backs, chests and arms.

Carter’s is aware of several reports from consumers whose children have experienced skin reactions while wearing apparel products containing heat-transferred, or "tag-less" labels, and unfortunately, some of these products have been identified as Carter's products. 14 Rashes You Need to Know: Common Dermatologic Diagnoses Lars Grimm, MD, MHS | October 19, | Contributor Information Skin rashes caused by bacterial, viral, or fungal etiologies are common presenting complaints to primary care clinics, emergency departments, and dermatologists.

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Evaluating the Febrile Patient with a Rash is gradual and no rash is present, as is the case in up to 20 percent of adults and rapidly evolves to a vesicular rash .

Skin Rash Types, Symptoms, Causes and Treatment