Common Rashes With Blisters

Do you know what's causing those blisters? Should you see a doctor or can you take care of it on your own? Take a look at some common rashes with blisters and see if you can find yours.

Chicken Pox:

Chicken pox is a highly contagious viral infection caused by the varicella virus. The word chickenpox comes from the Old English word "gican" meaning "to itch" or from the Old French word "chiche-pois" for chickpea, a description of the size of the lesion.

Who Gets Chicken Pox
Chickenpox is a disease of childhood - 90% of cases occur in children aged 14 years and younger. Before widespread vaccination, the incidence of chicken pox in the United States approached the annual birth rate, averaging between 3.1 and 3.8 million cases per year. Chicken pox can occur at any time, but occurs most often in March, April, and May in temperate climates.

Varicella Virus
The varicella virus is an enveloped, double-stranded DNA virus. It attaches to the wall of the cell it invades, and then enters the cell. The virus uncoats and is transported to the nucleus where the viral DNA replicates creating new virions that are eventually released from the cell to infect other cells.

Acquiring Chicken Pox
Chicken pox is acquired by direct contact with infected blister fluid or by inhalation of respiratory droplets. When a person with chicken pox coughs or sneezes, they expel tiny droplets that carry the varicella virus. A person who has never been exposed to chicken pox inhales these droplets and the virus enters the lungs, and then is carried through the bloodstream to the skin where it causes a rash. While the virus is in the bloodstream (before the rash begins) it causes typical viral symptoms like fever, fatigue, joint pains, headache, and swollen glands. These symptoms usually resolve by the time the rash develops. The incubation period of chicken pox averages 14 days with a range of 9 to 21 days.

Appearance of Chicken Pox
The chicken pox rash begins on the trunk and spreads to the face and extremities. The chicken pox lesion starts as a 2-4 mm red papule which develops an irregular outline (rose petal). A thin-walled, clear vesicle (dew drop) develops on top of the area of redness. This "dew drop on a rose petal" lesion is very characteristic for chicken pox. After about 8-12 hours the fluid in the vesicle gets cloudy and the vesicle breaks leaving a crust. The fluid is highly contagious, but once the lesion crusts over, it is not considered contagious. The crust usually falls off after 7 days sometimes leaving a craterlike scar. Although one lesion goes through this complete cycle in about 7 days, another hallmark of chicken pox is the fact that new lesions crop up every day for several days. Therefore, it may take about a week until new lesions stop appearing and existing lesions crust over. Children are not sent back to school until all lesions have crusted over.

Poison Ivy:

Poison ivy is known in medical terms as Rhus Dermatitis which is a type of contact dermatitis. As the name implies, a contact dermatitis is an irritation of the skin caused by contact with a specific irritant. In the case of poison ivy, the irritant is called urushiol which is a resin found in the plants in the Anacardiaceae family and the Rhus genus. Plants included in this classification are poison ivy, poison oak, and poison sumac. Also included are the cashew nut tree, mango tree, Japanese lacquer tree, and marking nut tree.

Poison Ivy
The appearance of poison ivy, oak, and sumac varies by regions and season. Poison ivy leaves are most likely to be in groups of three and notched, although they can be smooth edged. Poison ivy is usually found east of the Rocky Mountains growing as vines or shrubs.

Poison Oak
Poison oak leaves come in groups of three, five, or seven. They are smaller than poison ivy leaves and have smooth, rounded edges. Poison oak is usually found west of the Rocky Mountains as a small bushy plant or climbing vine.

Poison Sumac
Poison sumac has seven to thirteen leaves on one stem angled upward. They are smooth edged, oval and about 10 cm long. Poison sumac is found in boggy areas in the south.

Interesting Facts About Poison Ivy
In the United States poison ivy, poison oak, and poison sumac cause more cases of contact dermatitis than any other agents combined. Rhus dermatitis accounts for 10% of the US Department of Agriculture and Forestry Services lost time injuries. Twenty-five million to 40 million Americans require medical attention after being exposed to one of these plants.

Poison Ivy occurs from contact with the leaf or internal parts of the stem or root of the plant. Eight to 48 hours after exposure to urushiol the characteristic rash appears. This rash is typically red, contains blisters, and is in a linear or circular pattern. Urushiol can be found under fingernails, on clothing, and on tools unless it is deliberately removed. The resin itself can be active and cause a new rash for up to 3 weeks after exposure. Urushiol is not found in blister fluid and not responsible for spreading the rash. If untreated, the rash usually resolves in 3 weeks.

Treatment of Poison Ivy
The most common sites on the body for poison ivy are exposed areas on the arms, legs, and face. The intensity of the rash varies depending on the sensitivity of the person, and the amount and extent of exposure.

• Washing the skin with soap and water inactivates and removes the resin. Washing is most effective if it is done within 15 minutes of exposure.
• Cold, wet compresses are effective in the blistering stage. They should be used for 15 to 30 minutes several times a day for the first 3 days.
• Steroid creams or ointments are helpful to reduce redness and itching. Hydrocortisone can be used on the face, but is usually not strong enough for more than mild cases on the arms or legs. Typically, a prescription strength steroid is needed for these areas.
• Oral steroids are used for severe cases of poison ivy but must be used for at least a week.
• Short, cool tub baths with colloidal oatmeal (Aveeno) can be soothing and help control inflammation.
• Calamine lotion helps control itching but used too long can cause excessive drying of the skin and more inflammation.
• Antihistamines help reduce itching and the older types such as diphenhydramine (Benadryl) help encourage sleep.
• Any exposure to the eyes or eyelids or the development of a honey-colored crust should be evaluated by a health care provider.

Prevention of Poison Ivy

• Desensitization is not effective either by chewing leafs or having commercially prepared extracts injected.
• The most effective prevention is using a barrier to protect the skin. Clothing serves as an effective barrier but since the urushiol remains on the clothing, it must be removed carefully and laundered without contacting the skin.
• Urushiol can penetrate latex gloves but not rubber gloves.
• A lotion containing 5% quaternium-18 bentonite (IvyBlock) can be applied to the skin and provides a barrier for 4 to 8 hours. It must be washed off and reapplied for continued exposure.

The First Genital Herpes Outbreak:

Most people who are infected with the herpes simplex virus do not have symptoms. Of those who do develop symptoms, the first outbreak of genital herpes is worse than recurrences. The first outbreak is also associated with general symptoms aside from the rash. Women are at risk

of having a herpes infection that does not cause the usual symptoms.

Genital Herpes and Herpes Simplex Viruses
In the past, genital herpes was caused mainly by the herpes simplex virus type 2 (HSV-2). But now, new genital herpes infections are caused equally by the herpes simplex virus type 1 (HSV-1) and the herpes simplex virus type 2 (HSV-2). The majority of people who are going to get a primary outbreak will do so between 3 days to 2 weeks after exposure.

The First Genital Herpes Outbreak
The rash of herpes is a cluster of vesicles on a red base. In moist areas like the vagina, herpes may cause ulcerations instead of blisters. In women, the first outbreak of genital herpes can occur on the vulva, cervix, vagina, urethra, anus, buttocks, or thighs. Men usually get an outbreak on the tip of the penis or the shaft, but rarely around the base. Men who have sex with men may also get blisters in or around the anus. The rash in men is usually mild -- only 6 to 10 blisters. The blisters in men and women are painful and contain a large number of viral particles; therefore, they are very contagious.

Other Symptoms With the First Genital Herpes Outbreak
Seventy-nine percent of people get general symptoms with the first outbreak that usually resolve within a week. Some common general symptoms include:

• Fever to 102 degrees
• Headache
• Muscle aches
• Fatigue
• Swollen lymph nodes

Women and the First Genital Herpes Outbreak
Women are four times more likely to be infected with HSV-2 than men. For some reason, women have more severe disease and more complications during the first infection than men. If a woman gets a herpes outbreak on the cervix or vagina and not externally, she may develop vaginal discharge, pelvic pain, or burning with urination. With the first outbreak, some women may get a second round of blisters or ulcers in the second week.

How Long the First Genital Herpes Outbreak Lasts
The first herpes infection usually lasts for 2 to 3 weeks, but skin pain can last for 1 to 6 weeks. The blisters dry out and crust over. When the crusts fall off, the area is usually not contagious anymore. There is evidence that some people have low levels of virus present even when they do not have symptoms.