Paucis Verbis: Approach to rashes

Michelle Lin, MD on

PoisonOak

Doc, what’s this itchy rash?

Answer: Contact dermatitis from poison ivy

We see a variety of rashes in the Emergency Department. The first step is to accurately describe the rash. Is this a macule or nodule? Is this a vesicle or bulla? The next step is to quickly “profile” the rash to see if it fits any classic pattern by patient age, rash distribution, or presence of hypotension. And finally, if you are still stumped, use an algorithm based on the rash type.

Poison Oak rash

Contact dermatitis from poison oak

We see a variety of rashes in the Emergency Department. The first step is to accurately describe the rash. Is this a macule or nodule? Is this a vesicle or bulla? The next step is to quickly “profile” it to see if it fits any classic pattern by patient age, lesion distribution, or presence of hypotension. And finally, if you are still stumped, use an algorithm based on the rash type.

These figures are from March 2010’s Emergency Medicine Magazine. It’s not meant to be a comprehensive article on rashes but it sure does take the guesswork out of 90% of the rashes you see.

PV Card: Approach to Rashes


Go to ALiEM (PV) Cards for more resources.

Thanks to Dr. Hemal Kanzaria for including this idea as a PV card.

Author information

Michelle Lin, MD

Michelle Lin, MD

ALiEM Founder and CEO
Professor and Digital Innovation Lab Director
Department of Emergency Medicine
University of California, San Francisco

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Tags: ALiEM Cards Dermatology

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