The culprit for skin rash is almost always inflamation… Eczema, pityriasis rosea, lichen planus, and granuloma annulare are no exception to this rule. Below is some insight into each of these common skin rashes:

What is Eczema?

This term is used to denote a group of conditions that cause inflammation, redness of the skin and make it itchy and scaly. Atopic eczema or atopic dermatitis is the most widely spread form of eczema.

This condition can occur in adults as well as in children and it isn’t contagious.

What can cause this condition?

The exact causes of atopic dermatitis are unknown, but dermatologists claim that those with allergies in their family history are more prone to develop this condition. Asthma, hay fever or both can often accompany eczema, that is, in patients with this disease or in their family members.

There are several factors that can trigger or worsen this condition, but these are not the real causes. These factors include skin irritating products (soap, cosmetics or certain fabrics), stress, allergenic factors as well as the environmental conditions.

What does Atopic Eczema Look Like?

The way this condition develops is different in every person. Mostly, the symptoms appear in areas where we bend our elbows or knees, also on hands generally. Children with eczema often suffer inflammation on their neck, scalp, face, elbows or knees. Atopic eczema is usually accompanied by the following:

• Itching
• Red skin
• Scaly skin, dry and broken surface that often creates thick and leathery skin due to ongoing scratching
• Blisters filled with fluid – scratching causes them to open
• Broken areas of skin exposed to infection

Diagnosis of Atopic Eczema

For a doctor to diagnose this type of eczema, it is necessary to analyze a patient’s medical history of symptoms and examine the skin thoroughly. Testing of areas where the skin is broken and exposed to infections helps determine the presence of other diseases and conditions.

Treatment of Atopic Eczema

There are several topical treatments that are available for atopic eczema, many of these creams can be bought over the counter and contain steroid cortisone (Cortisone 10, Cort-Aid are some of them). They relieve itching and reduce the swelling and redness that eczema causes. More serious cases of this disease require pills or shots to be used along with ointments.

Topical immunomodulators (TIMs) are usually sufficient for patients with mild or moderate cases of eczema. This medication alters the response on the immune system to allergens and prevents the unpleasant flare-up associated with eczema. Product brands like Protopic or Elidel include TIMs. But in 2005, the use of these renowned brand names has been associated with cancer risk. The FDA has put a strong warning (a “black box” warning) on the packages of these two products to inform the doctors who prescribe this medication and the patients who use it. Because of the potential risks, only temporary usage of Elidel or Protopic is advised if other medication showed no results (only in adults or children older than 2 years).

Other treatment options

Antibiotics that deal with infected skin and antihistamines that relieve itching of the skin can be prescribed to eczema patients.

Thanks to sunlight and its ultraviolet waves, phototherapy provides relief for patients with various skin conditions, together with Atopic eczema. The UVA – ultraviolet light A or UVB – ultraviolet light B applied with specially made lamps has proved to be a beneficial procedure.

Improper application of the lamps can cause burns (similar to sunburn), dryness, itchiness, freckles and even early aging of the skin. This procedure requires the assistance of professional doctors for optimal effect.

Is Prevention Possible?

No cure for this condition is available at the moment, but proper treatment can improve flare-ups. By following certain principles, the patients can significantly improve their condition:

• Avoiding stress
• Excluding rough fabrics (itchy wool), strong skin care products, chemicals, soap, solvents and detergents
• Keeping the skin moisturized
• Not exposing the skin to sudden changes (heat and cold, humid and dry conditions)
• Avoiding sweat and overheating

What is Granuloma Annulare?

This chronic skin condition causes papules to appear on the skin. These are red bumps of a circular shape.

Young adults and children are most affected by this disease. Patients diagnosed with this condition are more commonly girls and in general they are people who rarely suffer from any diseases.

Why does Granuloma Annulare Develop?

Causes of this disease are unexplored so far.

How Can We Recognize Granuloma Annulare?

As mentioned above, papules, or circular bumps, can form on the back of one’s feet, hands and forearms. Several rings of these small firm bumps can appear at the same time and cause mild itchiness.

Diagnosis

Skin biopsy is often necessary for confirmation of this disease in a patient.

Treatment

Treating granuloma annulare is many times unnecessary. If a patient wishes to speed up the healing process for aesthetic reasons, creams or other topical products can diminish the papules. Even freezing with liquid nitrogen or injecting steroids into the rings of reddish bumps is often the choice of patients. Serious cases of granuloma annulare require phototherapy or drugs that can be taken orally.

Lichen Planus

This disease causes unpleasant bumps of an angular shape with a flat top. This shiny red, even purple swelling usually forms on the inner side of wrists and ankles, on the legs, even on the neck and the back area. This condition often causes symptoms to occur in the mouth, on nails, hair and around the genitals. One of the very common places for the bumps to form are the shins.

Patients who suffer from this condition are mostly between 30 and 70, the young or the elderly are affected less frequently.

The cause of most occurrences of lichen planus cannot be determined, however, patients with hepatitis C are prone to develop this condition.

Blood pressure or heart disease medication often causes allergic reactions that resemble lichen planus rashes. This disease isn’t contagious.

The signs of Lichen Planus

Red or purple shiny bumps with a flat top are indicators of lichen planus. Hair loss can accompany this condition if it forms on the scalp. Fragile nails that split and break are also a common symptom.

Diagnosis

The typical symptoms of lichen planus make it easy to identify, nevertheless, most doctors prefer confirmation with a skin biopsy. Testing a small piece of affected skin in a laboratory does this.

Treatment

There is currently no cure for lichen planus, but its symptoms can be reduced with medication that relieves itching thanks to antihistamines (Benadryl for instance). For a limited form of this disease, it is sufficient to apply the medication only on affected skin. Serious cases may require prednisone, retinoids or injections of steroids.

Phototherapy proved to be also helpful in many cases of lichen planus. A doctor is required for the proper application of the light lamps to achieve the best results.

What is Pityriasis Rosea?

This skin rash usually appears in mild forms. The most common places for this condition are the chest or the back. First a large scaly pink spot appears and is often accompanied by more of these patches, although the size and the number of these can differ from person to person. Red, itching skin and inflammation is common with pityriasis rosea.

Why does Pityriasis Rosea occur?

What causes this disease is currently unknown. There are some indications that the cause of pityriasis rosea is a virus. This is based on the resemblance to several viral diseases. This rash isn’t contagious.

Signs of Pityriasis Rosea

At the beginning a large scaly pink spot appears and is often accompanied by more of these spots. These lesions then start to itch, redness and inflammation is also common. Areas of the body that are usually affected are legs, upper arms, stomach, chest, neck and the back. Symptoms can vary with every person.

Diagnosis

The appearance of pityriasis rosea allows for a quick diagnosis. Blood tests and skin biopsy are often carried out to confirm the diagnosis and exclude other diseases.

Treatment

This condition does not require treatment in mild and even in more serious cases. Itchiness can be reduced with antihistamines (Benadryl and others) taken orally.

The swelled up bumps can also be treated with ultraviolet light or sunlight. Phototherapy should be carried out carefully. This condition often disappears within 6 to 12 weeks.