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Dermatologic Emergencies

A man grasps his right hand with his left hand, both hands are red and irritated from some form of skin condition.

Most people know that a dermatologist takes care of the skin, hair, and nails. Not as many know that there are serious internal medical diseases and disorders that include significant skin manifestations and even fewer people are aware that there are a number of conditions and circumstances that qualify as bona fide dermatologic emergencies.

Coming from the Latin, and first used back in the 17th century, the word "emergency" generally describes an unexpected, dangerous, or life-threatening situation that requires immediate attention and action, usually of a medical or surgical nature.

While it is true that the majority of skin rashes, blisters, bumps, and marks are common, other skin situations require immediate attention so it is helpful to have a basic idea of when it is okay to wait for a scheduled office visit, and when you should secure an emergency appointment with a dermatologist.

In many, if not most cases, it is more efficient and preferrable to be seen in a dermatologist's office because that eliminates the often long wait in a hospital Emergency Room or Urgent Care Center where a Board-certified dermatologist may or may not be immediately available.

Most skin rashes are common and can be caused by a number of things including bacteria, viruses, parasites, or allergies to environmental mold, dust, pollen, flowers, pet dander, etc.

Rashes can also occur if you come in contact with certain things to which you may
be sensitive. Common examples include latex, wool, chemicals in some
household cleaners, ingredients in some make-up or body lotion products,
and the fragrance elements added to items such as perfumes, body soaps,
and laundry detergent. Skin rash is a common response to ingested food
allergens, for example, shellfish, peanuts, peaches, pineapple, milk,
eggs, wheat, and soy, and skin manifestations are a common response to
medication allergy.

It isn't always easy for patients to correctly identify a danger from a routine skin rash or eruption which is why, under certain circumstances, an urgent visit to a dermatologist or general medical doctor is in order.

An intensely itchy, blistering rash may be the sign of a severe, even life-threatening allergic reaction that requires immediate medical attention --- or it can simply be the body's response to contact with a toxic plant such as poison ivy or oak.

It is a good idea to develop basic knowledge and awareness of some of the more common symptomatic warning signs that have the potential to become a dermatologic emergency.

The appearance of one or more should be your signal to make an urgent visit to a Board-certified dermatologist or visit the nearest hospital Emergency Room or community-based storefront Emergency Clinic. The warning signs include, but are not limited to the following:

Symptom 1

In addition to the relatively sudden onset of a generalized rash which may or may not be intensely itchy, you may also have trouble breathing may feel lightheaded or dizzy, you may be suddenly poorly coordinated, or you may have swelling of the lips, tongue, eyelids, or throat.

Symptom 2

You suddenly develop a generalized rash all over your body, particularly if you are taking a new medication or you have recently increased the dose of a medicine you have been taking for a while.

Symptom 3

You suddenly develop a rash that spreads quickly, becomes  blistered, or
is painful.

Symptom 4

You have been bitten or stung by a tick, bug, wasp, yellow jacket, hornet, bee, or fire ant. The injury site and nearby skin may be swollen, red, burning, blistered, itchy, and/or painful in addition to which you may or may not also feel dizzy, nauseous, short of breath, and you may feel a tightness in your chest.

Symptom 5

Joint pain and/or high fever accompany your generalized rash.

Symptom 6

Along with a generalized rash, you may have one or more of the following symptoms: difficulty swallowing, feeling of tightness in your throat, your voice suddenly sounds much lower/deeper than usual, and/or your tongue feels thick and you may have difficulty forming words.

Symptom 7

You notice sudden bleeding or red streaking on or beneath the skin of your generalized rash.

Symptom 8

Your rash has become infected. You would know this if whitish, greenish, or yellowish fluid is oozing from your skin, if any area of the rash is swollen, red, crusty, feels warm or hot, or if your skin has a foul odor.

Symptom 9

Cellulitis is a serious bacterial skin infection that often attacks the lower limbs. Legs may be swollen, hot, red, painful, and may have pus-filled abscesses. Skin may look dimpled and you may have a high fever. Cellulitis is thought to be the cause of nearly half of all urgent dermatologist or skin-related hospital Emerency Room visits. It can mimic several other conditions, so evaluation by a Board-certified dermatologist or other medical doctor is essential. If left untreated, the infection may spread through the body and blood and may be life-threatening.

Symptom 10

You either did not use or did not reapply adequate sunscreen protection and you have been over-exposed to the damaging rays of the sun. Also known as "sun poisoning," this is an extremely uncomfortabe, painful problem that has the potential for life-threatening complications if expsoure continues and/or if it is not treated. Moderately large areas of the body are generally involved and the skin has been severely damaged. It may be hot, angry red, blistering and injured to the point that wearing even a thin garment may be intolerable. While sun poisoning can, and often is treated at home, a dermatologist or other medical doctor can generally provide much more effective symptomatic relief, and may shorten the course of the condition. If not treated early and adequately either at home or by a dermatologist or other doctor, the symptoms of sun poisoning may linger for weeks and may increase a patient's risk for developing skin cancer.

What You Can Do

Dermatologic emergencies are not common but they generally progress rapidly and should be evaluated and treated urgently. If you are unsure whether your symptoms represent an emergent problem, please come in and see the Board-certified dermatologists at SINY Dermatology. Same day appointments are available, and we are here to help you. Call 800-778-3090 or visit sinyderm.com, to make an appointment.


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