Cellulitis is often overdiagnosed or misdiagnosed, and there are many conditions which can mimic it, says Rachel Bystritsky, MD, an infectious disease specialist and assistant professor of medicine at the University of California in San Francisco. If you develop a fever or the rash appears to be spreading, seek medical attention immediately as this can possibly be a sign of a serious complication (see below). Some people may also develop fever and chills. Why then, are doctors so concerned when a patient has cellulitis? mayoclinic.org/first-aid/first-aid-shock/basics/art-20056620, hopkinslupus.org/lupus-info/lupus-affects-body/skin-lupus/, sci.washington.edu/info/pamphlets/SCI_skin3.pdf, hopkinsmedicine.org/healthlibrary/conditions/dermatology/skin_pigment_disorders_85,P00304/, nhlbi.nih.gov/health/health-topics/topics/raynaud, my.clevelandclinic.org/services/heart/disorders/hic_Raynauds_Phenomenon/raynauds, Debra Sullivan, Ph.D., MSN, R.N., CNE, COI. Skip to content Care at Mayo Clinic Here, learn to spot it and what to do, Vasculitis refers to conditions that cause inflammation of blood vessels. (12). Theyll examine how the skin looks around the blanched area and request your medical history to determine any conditions that may contribute to the blanching of skin. Cellulitis Definition: Infection and inflammation of the deep dermis and subcutaneous tissue Epidemiology: Overall incidence of 24.6/1000 person years, increasing incidence with age, majority receiving outpatient therapy (Simonsen 2006) More prevalent in males, mean age ~45 years of age (Dong 2001, Ginsberg 1981) If this occurs, a person may need to stay in the hospital. Gangrene, MedlinePlus Medical Encyclopedia, last updated September 1, 2013; https://www.nlm.nih.gov/medlineplus/ency/article/007218.htm, last accessed January 8, 2016. There are numerous tests a doctor may recommend to diagnose vasculitic conditions, including: Treatment for vasculitis can vary depending on the type of the disease. These rashes might look similar to small red or purple dots or larger red or brown bruises. Philadelphia, Pa.: Elsevier; 2018. https://www.clinicalkey.com. Allergic reactions and insect bites can also cause blanching rashes, Friedman explained. She has worked in the hospital setting and collaborated on Alzheimer's research. Both experts recommend watching out for other signs and symptoms if you have a rash. For instance, because cellulitis starts as a local infection, it usually affects only one side of the body. It usually does not involve the deeper levels of tissue on the hand or finger. (14) On the other hand, lymphedema is a risk factor for cellulitis, because it makes the skin more vulnerable to infection. (8) Swelling around the ankles, discolored skin, and varicose veins can be early signs of the condition and should be reported to your doctor before your skin gets worse. Some social media accounts are sharing this test as a hack for parents to determine if a childs rash requires medical attention. Seek immediate medical attention if you or a loved one experiences any of the following symptoms in addition to blanching of skin: A doctor diagnoses blanching of skin by conducting a physical examination to determine potential causes. These are bothersome, but benign, he added. In this condition, dilated skin vessels result in a red, dusky discolouration of the legs when sitting or standing. Vasculitis means theres inflammation attacking the vessels to the point where the vessels are being damaged or even destroyed, said Friedman, adding that this can be caused by severe drug reactions and malignancy (cancers). Sources for Todays Article: In this article, we will explain what a non-blanching rash is and how to identify one. Youve noticed that the skin on one or both of your legs has become swollen and reddened, and its spreading. Acute eczema. If the rash progresses without explanation . that could potentially be more concerning and you should seek medical evaluation sooner rather than later, said Davis. Cellulitis presents as an enlarging area of red, hot, swollen, and tender skin. It is commonly caused by either Streptococcus pyogenes or Staphylococcus aureus. other information we have about you. health information, we will treat all of that information as protected health Here's what may be causing them and what you can do to ease your symptoms. If you have blanching of the skin and the cause has not been identified, it is important to speak to your healthcare provider. (10), Sometimes symptoms that look and feel like cellulitis are the result of your skin being irritated by something that it has touched, a condition known as contact dermatitis. Doctors will usually take a persons temperature, blood pressure, heart rate, and breathing rate. No, cellulitis doesn't itch. However, not everyone with ITP needs treatment. It's most common on the lower legs, but it. Read our. It is vital to distinguish this condition from cellulitis, because if a blood clot causing the DVT breaks off and travels to a lung, causing a pulmonary embolism, the result can be life-threatening. Sometimes, blisters form on the surface. Other risk factors include chronic oedema, lymphoedema, obesity, and diabetes mellitus. Sign Up for the Latest Health News and Tips, Home Skin Care Top 5 Cellulitis Symptoms. Cellulitis, Mayo Clinic web site, February 11, 2015; http://www.mayoclinic.org/diseases-conditions/cellulitis/basics/risk-factors/con-20023471. The main types of this condition are viral meningitis and bacterial meningitis. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). Arteries, veins, and capillaries throughout the body may be affected, Medical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. Leah Ansell, MD, is a board-certified dermatologist and an assistant professor of dermatology at Columbia University. Gangrene, MedlinePlus Medical Encyclopedia, last updated September 1, 2013; Meningitis, MedlinePlus Medical Encyclopedia, last updated January 7, 2014; Normandin, B., Cellulitis, Healthline web site; Sepsis Questions and Answers, Centers for Disease Control and Prevention web site, October 5, 2015; cellulitis can arise anywhere on the body, http://www.mayoclinic.org/diseases-conditions/cellulitis/basics/risk-factors/con-20023471, https://www.nlm.nih.gov/medlineplus/ency/article/000855.htm, https://www.nlm.nih.gov/medlineplus/ency/article/007218.htm, https://www.nlm.nih.gov/medlineplus/ency/article/000680.htm, http://www.healthline.com/health/cellulitis#Overview. DermNet does not provide an online consultation service. There are no systemic symptoms. According to a 2020 article, triggers for a non-blanching rash with no other symptoms can include: Health issues that can cause a non-blanching rash with other symptoms include: Autoimmune diseases occur when the body mistakenly attacks its own tissues and organs. Cellulitis is a common bacterial infection that develops in the layers of skin. The area of redness is usually more clearly defined than with cellulitis, and it may involve blisters or red streaking if the infection has spread along the lymph vessels. This roundup covers our top picks for best scar creams, from the best overall to creams for postsurgery, old scars, and fading discoloration. information submitted for this request. Sometimes, a non-blanching rash can be a sign of meningitis or sepsis, which are serious conditions. It can cause painful, hot to the touch, and red swelling on your body. It may be neutrophilic, lymphocytic or granulomatous on histopathology. By subscribing you agree to the Terms of Use and Privacy Policy. So a blanchable or blanching rash occurs when the redness (erythema) or discoloration disappears with pressure, but then returns because the blood is still inside the vessels so it's being moved around, he added. Cleve Clin J Med 2012; 79: 54752. Sherry Christiansen is a medical writer with a healthcare background. Venous eczema. Cellulitis is an acute infection of the dermis and subcutaneous tissues resulting in local pain, edema, warmth, and erythema. If the infection is on your arm or leg, prop that limb up above the level of your heart . Bystritsky R, Chambers H. Cellulitis and Soft Tissue Infections. Combinations can occur. This does not mean, however, that cellulitis is not more likely in some individuals than others: Cellulitis itself is not dangerous but it can lead to much more significant problems if not monitored properly. The reaction usually occurs 24 to 48 hours after contact. Clinical Methods: The history, physical, and laboratory examinations. They may also perform blood tests. Skin care & pressure sores. Recognizing the symptoms of cellulitis early and getting treated promptly is the best way to prevent these complications. The exact cause of vasculitis isn't fully understood. Still, there are clues that can point in the right direction. Pain from shingles, known as postherpetic neuralgia, can linger for weeks, months, or even years. Herpes zoster Purpuric rashes or vasculitis can also be caused by viruses like hepatitis C, autoimmune diseases, and even certain fungal infections in immunocompromised patients, Friedman explained. Nazarko L. The accurate diagnosis and treatment of lipodermatosclerosis. All rights reserved. Blisters: In some cases, blisters will form at the site and can possibly begin to leak yellow or clear fluid or even pus as your body attempts to combat the infection. Non-blanching rashes occur due to bleeding under the skin. I think a fever and a rash should always prompt some investigation, and absolutely fever and a non-blanchable rash, thats even more concerning, said Friedman. A number of skin conditions may 'mimic' cellulitis, and around 30% of cases of cellulitis are misdiagnosed. Dermatology Made Easybook. Distinguishing between cellulitis and these mimicking conditions is important to avoid unnecessary treatment and complications, and to expedite appropriate treatment. 5. Well go over the causes of an ear keloid before diving into. Staphylococcal and Streptococcal Infections. DermNet provides Google Translate, a free machine translation service. To provide you with the most relevant and helpful information, and understand which A person may require drugs, such as methotrexate or prednisone, to suppress the immune system. They will also take a blood sample to test for signs of an infection. The affected skin is swollen and inflamed and is typically painful and warm to the touch. Mosquito and flea bites are the most common causes, and children tend to have these reactions more often than adults because of their more sensitive immune systems. Venous eczema is not usually as red, hot, or oedematous as cellulitis. Chronic lipodermatosclerosis has a tethered down appearance due to, often irregular in shape and sharply demarcated, Dermatologic manifestations of necrotizing fasciitis, Patient information: Skin and soft tissue infection (cellulitis) (Beyond the Basics), An intense warm feeling in the area affected, Severe pain, seemingly disproportionate to the clinical findings, Oedema or tenderness extending beyond the. 1. 2. Amlodipine is a blood pressure pill used off-label to help treat the condition. Scientists use genetic rewiring to increase lifespan of cells, Beyond amyloid and tau: New targets in developing dementia treatments, Napping longer than 30 minutes linked to higher risk of obesity and high blood pressure. Necrotising fasciitis. Biopsywill usually showleukocytoclastic vasculitis. 4. The most common form of panniculitis is erythema nodosum, which can be distinguished from cellulitis by its bilateral and multifocal distribution, recurrent nature, and absence of oedema. Sepsis happens when an infection triggers a potentially life threatening immune response throughout the body. Topics AZ To tell the difference between the two, a person can press a drinking glass onto the affected area. Meningitis is a very serious medical condition. Some very pale or see-through skin is the result of a disease or condition such. In severe cases, you may need to be hospitalized and receive antibiotics through your veins (intravenously). Call your healthcare provider when: Blanching of the skin is when the skin remains pale for longer than normal after it has been pressed. A minority of patients with eosinophilic cellulitis may experience malaise and fevers but multiple lesions and the recurring history should distinguish it from cellulitis. 2023 Healthline Media UK Ltd, Brighton, UK. We will also look at some of the most common causes in children and adults, diagnosis, and potential treatment. Another important thing to look out for is how the rash is spreading. What Causes White Spots to Form on Your Nipple? Burning, sharp, or deep, achy pain that lasts for three months or longer after the shingles rash has healed. Keller E, Tomecki K, Alraies M. Distinguishing cellulitis from its mimics. DOI: Salmon M. Differentiating between red legs and cellulitis and reviewing treatment options. This content does not have an English version. Swelling of the calves above narrowed ankles (sometimes described as an 'inverted champagne bottle' appearance). However, there are times when theres not consistency between something blanching or not and being benign versus harmful, she said, adding that sometimes telangiectasia can be a sign of a more serious internal disease. Oedema is absent and the skin is not taut, smooth, or shiny. (9), Herpes zoster, the viral infection also known as shingles, can be mistaken for cellulitis. Cellulitis can occur anywhere on the body but is most commonly seen on the lower leg. (7) Lymphedema can be treated with compression garments, bandages, massage therapy, and sometimes surgery. All of these conditions can result in long-term disability or death if not spotted and treated quickly: Sepsis has three stages, but the first can be identified with the following acronym: The second stage is massive circulation disruption and clotting that features severe abdominal pain, decreased urine production, difficulty breathing, and gangrene among other un-pleasantries. Dermatologic Ther 2010; 23: 37588. You can test this on yourself if you press gently on an area of your skin, it likely turns lighter before resuming its natural color. information and will only use or disclose that information as set forth in our notice of If someone develops urticaria or hives, which can be due to a response to a food or medication that is blanchable, said Friedman. Thank you, {{form.email}}, for signing up. Necrotising fasciitis 10 Ways to Control Blood Sugar without Medication. The skin could be swollen, tender, and rashy on the legs. She adds that venous stasis dermatitis is typically bilateral (affecting both legs), a telltale sign that it is not cellulitis. Cellulitis is an infection of the deeper layers of the skin most commonly caused by bacteria that normally live on the skin's surface. All rights reserved. For example, if I push on my skin and it looks slightly pale when I release my finger thats because Ive temporarily pushed or stopped the blood flow to that area, Davis added. Ferri FF. But some psoriasis patients find that eliminating certain foods helps to clear their symptoms A new medicated patch for excessive underarm sweating may reduce symptoms for up to 4 months. Accessed Feb. 26, 2018. Bacterial meningitis can cause a non-blanching rash, said Friedman, and as well as other bacterial infections such as meningococcemia and gonococcemia. Healthline Media does not provide medical advice, diagnosis, or treatment. In the French language, blanc translates to white. Blanching of the skin occurs when the skin becomes white or pale in appearance. Cellulitis is an acute bacterial infection of the dermis and subcutaneous tissues of the skin. Cellulitis Symptoms and Signs. This is called blanching. Can diet help improve depression symptoms? If the rash appears to be growing in size or if the redness appears elsewhere on the body, it should be taken as a sign that the bacterium has begun spreading further.