Maculopapular Rash

What is Maculopapular Rash?

The term maculopapular rash is a general term assigned to all types of rashes with bumps on them. ^[1] This is so because maculopapular is a compound word including the terms macule and papule. A macule is simply a skin lesion less than 1cm in diameter, beyond which it is considered a patch, while a papule is a bump which is raised from the skin but not exceeding 1cm, beyond which it becomes a plaque. ^[2]

Normal Skin

As you can now see, extending this definition, there are several medical conditions that exhibit such a rash, and the term can be assigned to any skin rash which fits the definition. Some of the common conditions that present with a maculopapular rash include measles, scarlet fever, Zika virus and even a heat rash. ^[3]

Skin Layers

Signs

Knowing the definition of the term maculopapular, you can already picture some of the signs of a maculopapular rash. An individual can experience either macules or papules independently, or both combined. Some of the common signs include: ^[4]

Maculopapular Rash

• Redness of the skin – this is most evident in lighter-skinned individuals where the color is more pronounced. around these red macules, the skin color will remain the same as the rest of the body
• Swollen bumps – for those experiencing papules, there will be visible, reddened swelling protruding from the skin surface. in some cases, these bumps continue to swell and may rupture
• Tenderness – most maculopapular rashes will cause tenderness to the touch, and the individual may feel pain and itchiness

What Causes Maculopapular Rash?

A maculopapular rash can be caused by a very wide variety of medical conditions, but most individuals with the rash have been found to either have: ^[5]

• Syphilis – the first stage of syphilis, usually after contraction up to 6 weeks, will present with a maculopapular rash around the area of entry, which is usually the vagina, anus, penis, etc. Later on, the rash will spread to more and more parts of the body including the mouth
• Type 1 HIV – some people refer to maculopapular rashes as HIV rashes because they are very common among people who have the virus. The rash can be present in any part of the body and is usually painless
• Low cholesterol – when a person is found to have a lower than recommended level of cholesterol, they are likely to be given Niacin to manage the problem. Niacin raises the amount of high – density lipoprotein (HDL) cholesterol, which is the good cholesterol, but when given in high doses to raise cholesterol, it can cause maculopapular rashes to develop
• Dengue fever – a type of virus transmitted through the bite of a mosquito. Besides the more notable signs of fever and joint aches, it also causes a maculopapular rash around the area of the mosquito bite
• Rubella – also known as German measles, it is a mild form of measles and only lasts a few days, usually between 3 to 4 days. It causes the development of maculopapular rashes starting from the face and spreading down around the entire body
• Systemic diseases – some diseases affect multiple body tissues, including those on the skin leading to a maculopapular rash. Some examples of such diseases include Kawasaki disease and acute graft-versus-host disease
• Bacterial infection – when bacteria get into the skin, for example, due to physical contact, a maculopapular rash is likely to appear. The bacteria form a colony under the skin and lead to an immune response which subsequently causes the rash
• Reaction to medication – some people may also react to some prescribed medications and develop a maculopapular rash. Some of these drugs can be simple antibiotics like amoxicillin, but even chemotherapy medications can cause the rash in some people.

Diagnosis

As you can see from the possible causes, there can be very many reasons why a maculopapular rash develops. Yet it remains to be only a symptom, and not a medical condition on its own, which means that it is very important to find the underlying cause of the rash. This first involves a thorough assessment of the patient’s symptoms and medical history including previous medical conditions and any medications they may be taking. In this step, the doctor may have to examine your genitals to check for rashes and rule out STIs.

If, for example, the rash developed after the individual was prescribed a certain medication that can quickly lead to a conclusion. Other cases are simpler to determine, such as unprotected sex prior to the development of the rash. The doctor will also have to thoroughly examine the site to determine whether it is truly a maculopapular rash based on the characteristics described in the first section.

Afterward, laboratory tests are done to find other causes if the previous ones are eliminated. A sample may be collected from the site of the rash to form a culture to test for bacterial infections, while blood tests are done to check for other medical conditions.

Most often, however, the rash will develop around the problem area, helping the doctor to narrow down the source. For example, a rash starting from the head is usually a sign of measles, around the chest could be a symptom of pharyngitis and around the rash affects the private regions it is usually due to an STD. ^[6]

Treatment

Once the cause of the rash is identified, treatment is targeted at the specific cause, and the rash will disappear after a few days. This is usually the best way of treating a maculopapular rash because it targets the root cause. If the cause is a drug reaction, the doctor can alter your medication, reduce your dosage or offer you an anti-allergy medication to reduce the reaction. ^[7]

Nevertheless, some kinds of pain relievers may still be offered, often in the form of a cream, to reduce pain, irritation or itchiness caused by the rash. For more complicated causes of the rash, treatment options may be:

• Chloroquine – this is given if the rash is caused by the Chikungunya virus, also spread by mosquitoes just like Dengue fever
• Intravenous (IV) fluids – Dengue fever can be treated simply by taking water either orally or intravenously.

Pictures

References:

1. Definition of a maculopapular rash Available from: https://en.wikipedia.org/wiki/Maculopapular_rash
2. Details about maculopapular rashes Available from: http://bestpractice.bmj.com/best-practice/monograph/774.html
3. Conditions that may lead to a maculopapular rashes Available from: https://en.wikipedia.org/wiki/Maculopapular_rash
4. Signs of a maculopapular rash Available at: http://www.hxbenefit.com/maculopapular-rash-definition-symptoms-causes-differential-diagnosis-and-treatment.html
5. Causes of maculopapular rashes Available from: http://healthool.com/maculopapular-rash/
6. Diagnosing maculopapular rashes Available from: http://www.aafp.org/afp/2010/0315/p726.html
7. Treatment of maculopapular rashes Available at: http://healthool.com/maculopapular-rash/