Maculopapular Rash

What is Maculopapular Rash?

Maculopapular rash can be defined as the type of rash that is represented by macules and papules at the level of the skin. The combination between flat and raised lesions, on a red background, is found only in fair-skinned individuals. Because the lesions are often surrounded by the redness of the skin, this condition is often described as erythematous.

Symptoms of Maculopapular Rash

The maculopapular rash can be accompanied by a number of symptoms, depending on the underlying condition that has caused it to appear in the first place.

Fever

Fever appears as a sign of infection, ranging from moderate to severe. A high-running fever that does not give in to the treatment is a sign of a negative prognosis.

Itchy skin

In the situation that the maculopapular rash appears as an allergic reaction, itchiness may appear as a symptom. This manifestation is also present in infectious conditions, such as measles.

Redness of skin

The rash is often present on a red background, which is suggestive of the fact that the immune system is actively working to solve the problem.

State of general malaise

Often times, the rash appears as part of an infectious condition, which can tire out the entire body. As the immune system is working hard to get things back to normal, a state of general malaise can be present.

Loss of appetite

The appetite is often affected in viral conditions, especially since many patients also present nausea and vomiting. Because of that, subsequent weight loss might occur.

Causes of Maculopapular Rash

The maculopapular rash can appear at the level of the skin because of a number of causes. These are presented in the paragraphs that follow.

Scarlet fever

The maculopapular rash is characteristic for this infectious condition, appearing at a short distance after the fever. The rash becomes white under pressure, being present at the level of the chest and extending to the armpits, ears and even the groin.

Measles

The rash accompanies the rest of the symptoms, such as the cough, fever and conjunctivitis. The characteristic maculopapular rash appears on the skin a few days after the fever has produced. Present initially at the level of the ears, it extends quickly to the rest of the body, causing intense itchiness.

Ebola

The maculopapular rash is present in about half of the cases, appearing at several days after the rest of the symptoms have appeared.

Rubella

The maculopapular rash appears a couple weeks after the exposure to the virus, lasting only for three days. The rash begins at the level of the face and it spreads to the rest of the body (itchiness present/absent).

Congenital syphilis

The infection is transmitted in the prenatal period or during the actual born. The newborn will present the maculopapular rash in 70% of the cases, along with other symptoms (liver enlargement, fever, lung inflammation).

Miliaria

The maculopapular rash is characteristic for this condition, with intense itchiness accompanying the lesions that are present at the level of the skin. This condition is often triggered by hot and humid environments.

Medication

It is possible that the maculopapular rash appears as a side-effect of certain medication, such as antibiotics (amoxicillin in particular). Chemotherapy drugs can lead to similar problems, as well as niacin (when used in large doses, in order to reduce cholesterol levels).

Graft-versus-host-disease

The maculopapular rash has been observed in those who have undergone a hematopoietic stem cell transplant. It has been noticed that the rash appeared at a couple of weeks after the bone marrow transplant has been performed.

Marburg hemorrhagic fever

The maculopapular rash is one of the manifestations of this severe viral infection, along with the other hemorrhagic signs (petechiae, purpura, ecchymosis and hematomas). The rash appears in the first days of the disease (day 1-5).

Seabather’s eruption

The maculopapular rash has been diagnosed in people who have swam in the waters of the Atlantic. It is believed to appear in individuals who present specific sensitivity to the sea anemone and its larvae.

Arsenic intoxication

The maculopapular rash appears as one of the manifestations of acute arsenic intoxication. In general, it becomes evident at several weeks after the actual intoxication.

Pictures of Maculopapular Rash

Picture 1 - Maculopapular Rash on Back

Picture 2 - Maculopapular Rash on whole body

Picture 3 - Maculopapular Rash on back of neck

Picture 4 - Maculopapular Rash on stomach region

How is Maculopapular Rash Diagnosed?

There are a number of methods that can be used in order to diagnose the underlying condition that has led to the appearance of the maculopapular rash.

Medical history of the patient

The patient will have to provide information on the first time he/she notice the rash and if he/she has suffered from similar problems in the past. Information about the current and past treatments will have to be provided as well, so as to determine whether the condition has appeared as a side-effect of medication.

Physical examination

The doctor will analyze the macules and papules that are present at the level of the skin. He/she will also measure the temperature of the patient, so as to determine whether fever is present or not.

Laboratory studies

A complete blood count can be made in order to determine the leucocyte levels; if these are elevated, they can be suggestive of an infection.

Maculopapular Rash Treatment

The treatment of the maculopapular rash is addressed at the rash itself but also at the underlying condition that has led to its appearance.

Non-steroidal anti-inflammatory medication

This is a symptomatic treatment, which can be administered orally or topically. Among the recommended choices, there are: ibuprofen, naproxen and acetaminophen. The medication has the purpose of reducing the inflammation but also improving the discomfort/pain experienced by the patient. It can also bring down the fever.

Corticosteroids

These are administered with the purpose of bringing down the inflammation and also to reduce the intensity of the itchiness experienced by the patient. They can be administered topically or orally, depending on how severe the rash actually is. In more severe cases, the intramuscular administration is preferred. Corticosteroids cannot be administered for prolonged periods of time, due to the negative side-effects over one’s health.

Antihistamines

Antihistamines are generally recommended in patients who have suffered from an allergic reaction (for example, to medication). They can be administered orally or topically, reducing the inflammation and also the itchiness. However, in more severe cases, their level of effectiveness is reduced.

Antibiotics

Antibiotics are prescribed in the situation that the patient suffers from an underlying bacterial infection, such is the case with scarlet fever. The preferred method of administration is oral. Antibiotics have to be taken for as long as they are prescribed, otherwise the bacteria will develop resistance to the treatment. Probiotic supplements are administered at the same time, so as to maintain a healthy intestinal flora.

Intravenous hydration

This is recommended in the situation that the patient suffers from severe dehydration, as it happens in many severe infectious conditions. The intravenous hydration can prevent the consequences of dehydration, such as the vascular shock.

Blood transfusion

The blood transfusion is often resorted to in patients who present infectious conditions with hemorrhagic manifestations, such as the Ebola infection.

UV & gamma radiation

In the situation that the maculopapular rash is caused by the Marburg hemorrhagic fever, both UV and gamma radiation might be used as treatment measures.

Wet wraps

If the inflammation at the level of the skin is intense, with red patches causing a lot of discomfort, wet wraps might be used as adjuvants to the rest of the treatment. The wet wrap will have a soothing effect, calming the patient and bringing the necessary relief from the experienced symptoms.

Maculopapular rash in HIV infected

The maculopapular rash is one of the early signs that might raise suspicion about a potential infection with HIV. This is actually one of the manifestations of the immune system, as the response to the infection. Apart from the maculopapular rash, the patient might also exhibit flu-like symptoms, such as: moderate fever, soreness at the level of the throat, excessive tiredness, accelerated intestinal transit (diarrhea), muscle pain, swollen lymph nodes and joint aches.It is important to understand and remember that the maculopapular rash appears in the initial stage of the HIV infection. Even though any part of the body can be affected by this rash, it is commonly seen at the level of the face, chest and palms of the hands. The rash generally lasts for a couple of weeks and it is not characterized by other manifestations, such as itchiness, discomfort or irritation. In some patients, it might be accompanied by oral or genital ulcerations (not present in all).If you have noticed the appearance of such a rash, do not hesitate to schedule a doctor’s appointment and get yourself tested for HIV. The sooner you find out if you have been infected, the better the overall prognosis is going to be. Also, make sure to be on the lookout for the other signs of the HIV infection, as these might offer you a better idea on the potential result. As for other situations, going to the doctor is just as important, as it can help you get a treatment that is adequate for your own individual situation.