Approach to Patient with a Generalized Rash

Abstract

Background:Generalized rash is amongst the most common conditions presented to practicing General Practitioners and common differentials include contact dermatitis, atopic eczema, sun-induced damage, drug eruption and general manifestations of systemic diseases or infections.Materials and Methods:We illustrate with differential diagnoses our clinical case of a generalized rash in a 55-year-old man with pathognomonic signs of a diagnosis, which has received increasing global concern.Conclusion:Despite the array of available laboratory tests, a detailed history and physical examination is still of paramount importance to arrive at the most likely diagnosis for any patient with a generalized skin rash.

Cutaneous manifestations in elderly patients with confirmed coronavirus disease 2019 and the disease outcomes: A systematic review

“…Novak et al 39 proposed the process of SARS‐CoV‐2‐induced maculopapular exanthema, which includes the activation of immune cells (CD4 + helper T and CD8 + cytotoxic T lymphocytes) by antibodies to fight against the virus, causing extravasation of erythrocytes, cytokine release, and keratinocyte apoptosis, resulting in epidermal and dermal changes. Such eruption indicates a remarkably adequate immunity to SARS‐CoV‐2 infection, consistent with the relatively excellent prognosis in our study samples with maculopapular lesion 38 . However, an aggravated immune response may elicit a cytokine storm of predominantly pro‐inflammatory interleukin‐1 (IL‐1) and interleukin‐6 (IL‐6), causing vascular leakage, respiratory distress, and multi‐organ failure, 4 thereby expounding the unfavorable outcomes of a fraction with maculopapular lesions (29 out of 63 patients, 46.0%).…”

“…Maculopapular rash is the second most observed skin lesion (63 of 171 cases, 36.8%). It is an unspecific sign of COVID‐19, considering that dermatitis, sun exposure, drug allergies, and systemic infections also result in identical appearance 38 . The eruption extensively affects the trunk and extremities, with diverse presentations ranging from discrete and erythematous macules to multiple, confluent, and diffuse papules 13 .…”

“…It is an unspecific sign of COVID-19, considering that dermatitis, sun exposure, drug allergies, and systemic infections also result in identical appearance. 38 The eruption extensively affects the trunk and extremities, with diverse presentations ranging from discrete and erythematous macules to multiple, confluent, and diffuse papules. 13 Novak et al 39 proposed the process of SARS-CoV-2-induced maculopapular exanthema, which includes the activation of immune cells (CD4 + helper T and CD8 + cytotoxic T lymphocytes) by antibodies to fight against the virus, causing extravasation of erythrocytes, cytokine release, and keratinocyte apoptosis, resulting in epidermal and dermal changes.…”

“…Such eruption indicates a remarkably adequate immunity to SARS-CoV-2 infection, consistent with the relatively excellent prognosis in our study samples with maculopapular lesion. 38 However, an aggravated immune response may elicit a cytokine storm of predominantly pro-inflammatory interleukin-1 (IL-1) and interleukin-6 (IL-6), causing vascular leakage, respiratory distress, and multi-organ failure, 4 thereby expounding the unfavorable outcomes of a fraction with maculopapular lesions (29 out of 63 patients, 46.0%).…”

Perspectives of community pharmacy staff on commonly encountered skin conditions and the key challenges towards enhancing their role in dermatology

“…Generalised skin rash in particular, ranked as the second most commonly encountered condition in the present study, can have a range of common differentials, such as contact dermatitis, atopic eczema, or manifestation of systemic disease. 6 There is particularly a need to focus on improving the ability to diagnose minor ailments commonly encountered in community pharmacy. Eczema/dermatitis was ranked as the most commonly encountered skin condition, and these results are supported by previous studies exploring pharmacists' perceptions on the range of skin conditions they encounter.…”