Life-Threatening Skin Rashes Symptoms

• Pemphigus vulgaris (PV)
  
  
  • PV happens more commonly in adults aged 40-60 years, but it has been found in children as young as 3 years and as old as 89 years.
    
    
  • PV affects both women and men equally.
    
    
  • The painful blisters found in PV are irregularly shaped, elevated skin lesions, usually more than one-half inch across.
    
    
  • The blisters can form on either normal skin or reddened skin.
    
    
  • Lesions usually start in the mouth and may be found on the lips, tongue, throat, and the inside of the cheeks.
    
    
  • Painful blisters in the mouth make drinking and eating difficult.
    
    
  • Blisters then spread to the head, face, and armpits, before moving on to the rest of the body.
    
    
  • As they form, blisters are initially tense and filled with clear fluid.
    
    
  • If you press on the skin next to a blister, the blister will either extend or a new blister will form.
    
    
  • After 2-3 days, the blisters become loose, and the fluid within the blister becomes cloudy.
    
    
  • At this stage, the blisters break easily, leaving a very painful area of raw skin underneath that quickly crusts over.
    
    
  • These open sores are very susceptible to infection.
    
    
  • Because the blisters can cover a large portion of the body surface, infection can be severe and easily spread into the blood.
    
    
  • If not treated, these severe infections may lead to death.
  
  
• Stevens-Johnson syndrome (SJS)
  
  
  • SJS occurs in all age groups but is more common among those aged 20-40 years.
    
    
  • SJS affects men twice as often as women.
    
    
  • The early symptoms include fever, muscle and joint pains, generalized fatigue, and itching or burning sensations in the skin.
    
    
  • The SJS rash starts in the mucous membranes, usually of the mouth and eyes, and may involve other mucous membranes in severe cases.
    
    
  • Then the skin lesions common to SJS develop. These lesions are often called "target lesions" because they have a bluish or purple center surrounded by a circle of red.
    
    
  • These lesions start as reddened spots about 1 inch around and usually appear in clusters.
    
    
  • Although the rash may start anywhere on the body, it typically involves the feet, hands, and the front of the legs and arms more frequently than the chest, abdomen, or back.
    
    
  • The rash usually occurs on both sides of the body.
    
    
  • Within 1-2 days, the rash develops into the typical target lesion.
    
    
  • The centers of the lesions may become bluish or purple with a surrounding halo of redness.
    
    
  • Blisters then form in the centers of the lesions and may itch or be painful.
    
    
  • Target lesions usually appear in successive crops over the body and may run together, forming one large lesion.
  
  
• Toxic epidermal necrolysis (TEN)
  
  
  • TEN occurs in all age groups but normally affects adults.
    
    
  • TEN occurs twice as often in women as men.
    
    
  • TEN is thought to be a more severe form of SJS.
    
    
  • Early symptoms of fever, fatigue, joint and muscle pains, cough, nasal congestion, and runny nose may be present along with general skin tenderness up to a week before the onset of skin rash.
    
    
  • Mouth lesions and conjunctivitis, or red eyes, may be present 1-2 days before the skin rash occurs.
    
    
  • The skin rash usually starts on the face or genitals and rapidly moves to the rest of the body.
    
    
  • The skin becomes reddened and is painful to touch.
    
    
  • Large blisters can run together, and large sheets of skin peel from the body.
    
    
  • Eye involvement is serious, usually leads to pus drainage from the eyes, and may result in blindness.
    
    
  • On average in TEN, up to 50% of the body surface is affected.
    
    
  • The loss of skin leads to large amounts of fluid loss through exposed surfaces and increased risk for infection.
    
    
  • The rash may also be found in the linings of the respiratory and gastrointestinal tracts.
    
    
  • Without medical attention, TEN may result in death.
  
  
• Toxic shock syndrome (TSS)
  
  
  • TSS occurs in teens to young adults aged 15-34 years.
    
    
  • Two-thirds of people with TSS are younger than 25 years.
    
    
  • Four out of 5 are female.
    
    
  • Symptoms begin up to 2 days before the onset of skin rash and include fever greater than 102°F, sore throat, headache, fatigue, nausea, vomiting, and diarrhea.
    
    
  • TSS may involve the mucous membranes with red, irritated eyes, and a beefy-red tongue.
    
    
  • Dizziness or a light-headed feeling when standing up is also common.
    
    
  • Joints and eyelids also may swell.
    
    
  • A diffuse red rash then rapidly appears that may cover most or all of the body.
    
    
  • If you press on the red areas of skin, the skin will blanch, or turn white. Releasing pressure will cause the redness to return.
    
    
  • The skin remains flat with no raised areas, bumps, or blisters.
    
    
  • Other organ systems also are affected by TSS, and TSS may lead to kidney, liver, respiratory, and heart failure. The brain may also be involved leading to confusion or disorientation.
    
    
  • Shock occurs when the cardiovascular system is unable to maintain blood pressure, leading to dizziness or lightheadedness when standing.
    
    
  • The rash will usually disappear in about 3-5 days.
    
    
  • During recovery, after the rash is gone, skin on the palms of the hands and soles of the feet begins to flake and peel off. In severe cases, fingernails, toenails, and hair may fall out. Other areas of skin may also begin to flake and peel.
  
  
• Staphylococcal scalded skin syndrome (SSS)
  
  
  • SSS is a disease found in children, typically aged 6 months to 6 years.
    
    
  • Initial symptoms include fever and irritability, and areas of skin may be tender before the rash breaks out.
    
    
  • The rash in SSS comes on suddenly and begins in places where your skin has creases: armpits, groin, neck, and around the mouth and eyes. It then quickly spreads to cover most or all of the body.
    
    
  • The skin is red, warm, tender to touch, and has a sandpaper texture.
    
    
  • The rash is similar to that found in scarlet fever, a less harmful disorder. The difference between scarlet fever and SSS is that in SSS the rash is painful to touch.
    
    
  • About 1 day after the onset of the rash, the skin begins to wrinkle and form large, irregular, loose blisters.
    
    
  • The blisters break open easily, and the outer layer of skin peels off in sheets over the next 3-5 days.
    
    
  • As the skin blisters and peels, it looks as if it has been scalded, which led to the name of the disorder. Raw skin underneath the blisters dries out quickly after the skin peels off and heals in the next 10-14 days.