A rash without itching

The human skin displays many reactions and processes that occur inside the body. Therefore, there is nothing strange in the fact that periodically various rashes appear on the skin. And this is not only a cosmetic problem: a rash without itching can be the "first bell" of the development of infectious, toxic or other pathology. Therefore, this symptom should not be ignored: you should see a doctor, conduct a diagnosis, find the cause of the violation and eliminate it.

Causes of the itchless rash

Rashes without itching in the form of spots, blisters, nodules, pimples, etc., can occur under the influence of physical, chemical and other factors. Direct causes may be:

• infectious process (microbial, viral, less often fungal);
• Allergic reaction (contact, drug, food, etc.);
• diseases of blood vessels and blood (vasculitis, leukemia, etc.);
• autoimmune pathologies (in particular, systemic lupus erythematosus);
• intoxication, a side effect of drug therapy.

Let's look at the most common causes of rashes without itching.

• Measles is an infectious pathology that is transmitted by airborne droplets from a sick person infected with the measles virus. The virus is highly contagious, so contact with the infection makes all unvaccinated and previously unvaccinated people sick. [1]
• Rubella is a viral infectious disease that can be congenital or acquired. Acquired disease is transmitted by airborne droplets, is more often accompanied by moderate symptoms and has a favorable prognosis. Congenital rubella is transmitted from the mother to the future baby through the placental layer and causes the formation of severe developmental defects. The greatest danger is rubella in a woman in the first trimester of pregnancy, during the laying of the main organs and systems of the child. [2]
• Scarlatina is an infectious disease caused by B-hemolytic group A streptococcus. In addition to scarlatina, this bacterium causes the development of such pathologies as rye, streptoderma, streptococcal sore throat. The mode of transmission is airborne and household contact. [3]
• Pseudotuberculosis (yersiniosis) is a bacterial disease caused by the causative agent Yersinia tuberculosis (pseudotuberculosis bacillus). Symptomatology of the disease is usually represented by toxic-allergic signs, scarlatina-like rash, pathological manifestations on the part of the digestive system. The source of infection is rodents: mice, rats. Human infection is possible by eating products infected with feces of diseased animals. [4]
• Intestinal yersiniosis is an acute infection provoked by Yersinia enterocolitica. Probable source of infection: sick person, rodents, soil. Infection occurs by eating contaminated meat, fish, milk, fruits and vegetables, drinking raw water, and contact with diseased animals. The disease affects the digestive system, liver, joints, and causes signs of general intoxication. [5]

There are also non-infectious causes:

• physical (cold, heat, ultraviolet radiation, vibration, squeezing);
• Contact (water, cosmetics and household chemicals, latex products, etc.);
• Food (hypersensitivity to certain foods);
• medication (use of antibiotics, local anesthetics, etc.);
• inhalation;
• provoked by insect bites;
• caused by malignant processes;
• caused by hormonal changes (particularly during pregnancy);
• autoimmune;
• caused by genetic abnormalities.

A rash without itching can also be a sign of a deadly pathology, for example:

• meningococcemia - a generalized form of meningococcal infection characterized by hemorrhagic rash, severe intoxication and rapid development, which requires emergency medical intervention; [6]
• severe allergic reaction - anaphylactic shock, which is accompanied by acute swelling of the extremities, oropharynx, tongue, respiratory distress and depression of consciousness. [7]

In such cases, an ambulance should be called immediately.

Risk factors

Risk groups for all kinds of rashes without itching include:

• people who are prone to excessive sweating, grease production;
• People with weakened immune defenses (e.g., patients undergoing chemotherapy or glucocorticosteroid treatment);
• people who frequent public places (gyms, swimming pools, etc.);
• who prefer clothes and shoes made of synthetic materials with insufficient ventilation;
• neglecting personal hygiene recommendations, using other people's towels, shoes, bedding and underwear;
• patients who have recently had infectious-inflammatory processes, who have undergone a course of antibiotic therapy;
• living in endemically insecure areas;
• working in conditions of high humidity, temperature;
• obese, diabetics, HIV-positive people.

Pathogenesis

The skin is the largest human organ in terms of size. They perform the most important functions for the body: they provide metabolism, heat regulation, protection, and receptivity. The skin consists of these layers:

• epidermal, the outer layer, which in turn is represented by five layers that provide mainly barrier protection;
• dermal layer of connective tissue, localized between the epidermis and the organs below, from which the dermis is separated by subcutaneous tissue;
• subcutaneous tissue, represented by a loose connective tissue structure with fatty inclusions.

The stratum corneum provides protection: it is devoid of living structures and includes only dead cells. It varies in thickness. The water-fat mantle covers the stratum corneum, enhancing its protective properties. It maintains a certain level of acidity, which in the norm is 4.5-5.5. In many skin diseases of the rash type without itching (mycoses, acne), the acidity index changes.

The water-fatty mantle has its own microflora. It can be represented by a multitude of symbiosis of microorganisms, including fungi, epidermal staphylococcus, etc. Such microorganisms ensure the constancy of the acidic environment on the skin and prevent the entry of infection. However, under certain circumstances, the balance is disturbed, and the bacterial picture can shift in one direction or another. In addition, the protective barrier function can deteriorate, which contributes to skin infection. All of this can influence the appearance of a rash without itching.

In infectious lesions, the mechanism of development of pathological rashes is somewhat different. In particular, in scarlatina, the infectious agent produces exotoxin, which determines the development of toxic manifestations in the form of a rash without itching. In measles, perivascular foci of inflammation are formed, due to viral damage to the vascular endothelium, perivascular exudation and cellular infiltration. By the way, the elements of rashes in measles always contain the causative agent.

In non-infectious cases, we are talking about other pathogenetic mechanisms, in particular, the influence of histamine, activation of the complement system, the impact of parasites and their products. Autoimmune pathology is not excluded.

Epidemiology

Rash without itching most often bothers owners of excessively dry or, conversely, oily skin, prone to acne, vascular defects, hyperpigmentation and other external manifestations. Precede the appearance of rashes, general diseases, enlarged pores, blackheads, etc. With such symptoms are often faced by adolescents and patients suffering from endocrine or digestive pathologies.

Even on outwardly perfect skin can appear rash without itching, which is associated with hormonal changes, stress, unfavorable environmental conditions and other factors that negatively affect the body. The most susceptible to the appearance of rashes is problem skin.

The appearance of a rash without itching can occur at any age, but most often the problem appears in early childhood and adolescence. According to statistics, this symptom is especially common in infants and children from 12 to 25 years of age, regardless of the patient's gender.

The highest frequency of infectious pathologies is noted in early childhood. Accordingly, infection-caused rash without itching is more common in pediatrics, in children of preschool age.

Symptoms

A rash without itching may vary depending on the type of lesion:

• Spots - These are elements less than 1 cm in diameter that are not palpable on palpation. They are essentially just limited areas of discoloration that do not rise or fall when compared to the surrounding tissue.
• Papules are protruding elements of the rash that can be palpated, with a diameter of up to 1 cm.
• Plaques are rashes that can be felt because they are raised or sunken compared to the surrounding skin. Plaques can be rounded or flat.
• Nodules are thickened papules or rashes without itching that spread into the dermal or subcutaneous fat layer.
• Vesicles or vesicles are hollow rashes with clear fluid inside. The elements are small (less than 1 cm), transparent. If the size exceeds 1 cm, they are called blisters.
• Pustules are the same vesicles, but with purulent contents. They are often caused by bacterial infections and inflammatory diseases.
• Urticaria is a raised rash without or with itching that results from localized swelling. Otherwise, these rashes are called blisters.
• Scales - areas of accumulation of particles of stratum corneum epithelium, which is especially characteristic of mycoses and psoriasis.
• Petechiae - dots, which are small hemorrhages that do not turn pale and do not disappear when pressed with a finger. Such rashes are characteristic of meningococcemia, thrombocytic pathologies, vasculitis, etc.
• Telangiectasias are small areas of dilated blood vessels that occur with systemic or hereditary pathologies, or with prolonged treatment with fluorinated glucocorticoids.

First signs

The initial stage of diseases is characterized by certain first signs, such as:

• In measles, intoxication symptoms are sharply pronounced: fever, head, joint and muscular pain. Then catarrhal symptoms are added (cough, nasal itching, runny nose, lacrimation, photophobia). The rash is detected on the third day: first in the face and neck, then - on the shoulders, chest, abdomen, back, limbs. Rash on the face without itching, with a tendency to spread "from top to bottom" is a characteristic sign of measles. Possible change of rashes with spots of pigmentation, which persist for several weeks. The mucous membranes are also covered with small spots of whitish color, especially on the inner surface of the cheeks. [8], [9]
• Rubella has an acute onset, with a slight fever, moderate catarrhal signs, and enlarged and painful lymph nodes. Rashes also appear almost immediately. At first it is a rash without itching on the chest, then spreads to the abdomen and the rest of the body, including the limbs, face, back. The vast majority of rashes remain localized in the chest area. The elements of the rash are dull, pale pinkish in color. [10]
• Scarlatina has a symptomatic triad: skin rash, fever and severe redness of the throat with pus in the lacunae. The onset of the disease is acute. The rash without itching is small-pointed, occurs in a few hours from the start of the pathology and quickly (within a couple of hours) spreads over the body, starting from the face to the neck, chest, abdomen, extremities. A characteristic sign: when lightly running the palm of the hand over the surface of the skin feels pronounced dryness and roughness, as if the body is covered with "goosebumps". Submandibular lymph nodes enlarge, the tongue first becomes whitish (with plaque), then - bright crimson, smoothed. [11]
• In pseudotuberculosis, there is initially a sharp rise in temperature, abdominal pain and nausea, and fever. There may be enlargement of the liver and spleen, joint pain and diarrhea. A rash without itching is found all over the body: it is reddish-blue, small-pointed (similar to that in scarlatina), more pronounced in the areas of natural skin folds, prone to confluence. Other characteristic features: pale nasolabial triangle, the symptom of "gloves" (rash on the hands without itching), "socks" (rash in the feet) or "hood" (rash in the neck, face and shoulder girdle). The skin is dry, rough. The pharynx is red and inflamed, but there is no purulent tonsillitis. [12]
• Intestinal yersiniosis has an acute onset: the patient complains of generalized weakness, abdominal pain, nausea, diarrhea. The rash without itching resembles that of measles. It is localized mainly in the skin folds, on the sides of the torso, in the area of the joints. There may also be pain in the head, throat, muscles and joints, nasal congestion. Sometimes lymph nodes and liver are enlarged. [13]
• In non-infectious diseases, different types of rashes can appear on the legs without itching. Most often they are whitish or pale pinkish blisters protruding above the skin surface. They usually appear suddenly and also disappear abruptly (within 24 hours). They tend to merge and form large areas of irregularly shaped lesions.

Before heading to the doctor, it is important to pay attention to the following points:

• what kind of rash without itching (color shade, size);
• its localization, its abundance;
• A possible connection to an event or contact;
• associated symptoms.

A rash without itching can be different, and the patient himself is not always able to determine its origin. Therefore, you should always see a medical specialist.

A red rash without itching is also characteristic of viral diseases, including COVID-19. Such rashes do not depend on the severity of the infectious process and can appear even in asymptomatic patients. The following rashes in adults without pruritus due to coronavirus infection have been observed:

• Unsymmetrical spots resembling a reaction of frostbite in the area of hands and feet, sometimes painful when touched. Such a rash without itching and fever was observed mainly in patients with a mild course of the disease and passed independently after about 12 days. The incidence of the symptom is about 19%.
• A focal, itchless, transient rash of small vesicles on the body and extremities. The symptom appears simultaneously with other pathologic signs and persists for about 10 days.
• Rash on the abdomen without itching, outwardly resembling urticaria, with a pinkish or whitish tint. It is less common in the extremities and palms.
• Maculopapular rashes in the form of flattened or protruding vesicles, with the frequency of occurrence - about 47%. The duration of existence of such elements - about 7 days, more often against the background of a severe course of coronavirus infection.
• Small rash without itching in the form of bluish-red vascular network. Occurs in 5-6% of patients with severe COVID-19.

Doctors note that rashes can have both infectious and other origins, so this symptom requires mandatory differential diagnosis.

A rash without itching in a baby

A small reddish rash without itching is the most common type of rash found in children of early childhood, preschool and primary school age. Small dots without purulent content sometimes appear in the head, armpits, shoulder girdle, abdomen and back, perineum. Such a rash is characteristic of allergic reactions, but often occurs as a result of overheating and poor hygiene. The consequence of neglecting hygiene becomes diaper rash, sweating. In infants, a rash without itching often appears on the head, because it is through the scalp of the baby is thermoregulation.

Rashes without itching also occur in certain diseases of viral and microbial nature, with scarlatina, measles, leukemia. Watery rash in most cases is a symptom of herpetic and pustular infections, allergic processes, insect bites and ultraviolet exposure.

The appearance of a bubbly rash in the area of hands and feet may indicate dyshidrosis - blockage of sweat glands, or fungal lesions.

Purulent rashes are more characteristic of infectious diseases of microbial etiology - in particular, for lesions of Staphylococcus aureus.

What should parents do when they see a rash without itching on the skin of the child? First of all, it is necessary to take a good look at the baby's skin, to determine the type of rashes, their size and other features. It is important to remember and analyze what may have caused the problem. Then you should measure the temperature, examine the throat, tonsils, and then go with the child to the clinic or, if necessary, call a doctor at home (for example, if the baby is supposedly contagious). It is strictly forbidden to prescribe treatment for children on their own. [14]

Diagnostics of the itchless rash

Treatment of a rash without itching should be started only after determining the actual cause of its appearance. Improper treatment approach can cause a worsening of the problem. The type of treatment depends entirely on what was the provoking factor for the rashes.

What can be used for diagnosis:

• skin scrapings;
• Sampling the contents of vesicles and pustules;
• collection of blood, urine, and stool tests.

If necessary, an additional consultation of an allergist, infectious disease specialist, pediatrician, gastroenterologist, endocrinologist and other narrow specialists is appointed.

Appropriate tests are ordered when infectious and allergic diseases are suspected:

• detection of class M immunoglobulins (measles, IgM virus antibodies);
• determination of immune memory marker for rubella, detection of primary rubella infection;
• determination of marker of sensitization of the organism to streptococcal antigens, bacteriological sowing and antibioticogram of biomaterial from tonsils in case of suspected scarlatina;
• Screening of inhalant, mixed, drug, food allergies;
• Determination of DNA of the causative agent of fungal infection by PCR;
• determination of IgG antibodies to fungal pathogens.

Depending on the indications, it may be necessary to analyze cerebrospinal fluid, assessment of biochemical values of body functionality (liver tests, indicators of water-electrolyte composition of blood and nitrogen metabolism, etc.).

Instrumental diagnosis can be represented by such studies:

• X-rays (helps to assess the volume of affected tissue - for example, in respiratory infections);
• ultrasound (helps to visualize internal organs, detect pathological neoplasms);
• computerized tomography (allows you to look at the affected internal organs layer by layer).

Differential diagnosis

The characteristic of rash without itching has differential diagnostic value: it is important to note the period of occurrence, dynamics, sequence of appearance, localization, distribution, duration of rashes.

The main diagnostic differentiations are summarized in the table:

Measles	Spotty-papular rash without itching, prone to coalescence, appearing in stages: on the first day - in the face, neck, upper thoracic segment and shoulder girdle; on the second day - the trunk is completely covered with rashes, spreading to the upper extremities; on the third or fourth day - spreading to the lower extremities. Fusion of the rash in the face leads to puffiness, thickening of the eyelids, coarsening of facial features, a pronounced change in appearance.
Scarlatina	A small pitting rash without itching appears on the first or second day of the disease, localized on reddened areas of the neck, upper thoracic segment, back. Over the course of the day, it spreads to the whole body. There is an accumulation of rashes in the area of skin folds (neck, armpits, groin, hamstrings, etc.).
Rubella	A rash without itching occurs within 24-48 hours of disease onset. It rapidly spreads to the face, chest, abdomen, back, arms and legs. The rashes are finely spotted, the elements have even configurations, pale pinkish, abundant. The spots do not rise above the surface of the skin, pale when pressed. The accumulation of spots is observed in the area of limb extension, as well as on the back and buttocks. The background of rashes - normal skin. The rash without itching does not leave pigmentation and passes within 2-4 days.
Pseudotuberculosis	A rash without itching appears in the first or second day of the disease, one-stage, more often - like scarlet fever (small dot). The color range - from pale pinkish to bright scarlet-blue. The skin background also varies. Localization is symmetrical. In some cases, itching may be present. Rashes disappear for 24 to 144 hours.
Enterovirus infection	Rash without itching occurs at one moment, on the background of unchanged skin. Main elements: spots, papules, small dots, hemorrhages. They disappear without trace within 24-48 hours.
Meningococcemia	Rash without itching appears in the initial 24 hours of the disease. It is distinguished by diversity and different sizes: the elements are represented by spots, papules, hemorrhages, "stars" of irregular configuration with a thickening in the center. The nature of rashes - gradual, with increasing dynamics. Dominant location: buttocks, legs. Skin background - without changes. As intense rashes disappear in some places, areas of necrosis are formed.
Typhoid fever	Roseolae are present in the form of pinkish spots about 2-3 mm in diameter, pale when pressed. Appear on day 8-10 of the disease, prone to periodic replenishment. They disappear without trace in 24-120 hours.
Herpetic infection	There is a localized rash on a limited area of the skin, on which there is pain, burning, redness, and only then - vesicles with serous content. The skin is edematous, reddened. After opening are found wet erosions, covered with crusts with subsequent epithelialization. Predominant localization: lip border, nose, cheeks or forehead, buttocks and thighs, forearms, hands.

Treatment of the itchless rash

Treatment of patients with a rash without itching is different, because it depends on the origin of this symptom, on the cause of its appearance.

There are many different medicines that can successfully relieve a person from any dermatological rashes, including allergic and infectious rashes. The choice of a suitable drug is carried out only by a doctor, after preliminary determination of the etiology of the pathological process and diagnosis.

In an allergic process, for example, treatment begins with stopping the action of the allergen, after which medication is carried out to eliminate the pathological signs directly with the help of antihistamines and other drugs. It is recommended to take such medications as Loratadine, Desloratadine, Diazolin, Suprastin. In complicated cases of rash without itching, it is possible to use hormonal drugs - in particular, ointments with prednisolone or hydrocortisone.

Patients with infectious diseases are prescribed appropriate drugs as part of a complex therapy. This can be antibiotics, sorbent and detoxification drugs, antiviral agents, immunoglobulins and so on. In particular, patients with bacterial dermatitis of staphylococcal or streptococcal nature are definitely prescribed antibiotics of a wide range of antimicrobial activity. Recommended drugs of the macrolide group (Azithromycin), often prescribed and Ceftriaxone. Most patients with pyoderma note improvement after regular treatment of areas with a rash without itching with solutions of fucorcin or brilliant green.

Viral pathologies often do not require the use of specific therapy. Doctors prescribe a course of immunostimulants, multivitamins that improve the immune response of the body and contribute to the rapid relief of clinical signs of the disease.

If the rash without itching is caused by a violation of sweating, it is recommended to carefully observe the rules of personal hygiene, wear clothes and shoes made only of natural quality materials, if necessary - use powder. A good effect is observed from the use of zinc ointment, which has a drying effect.

In fungal infections, appropriate antifungal therapy with drugs with targeted antimycotic action is prescribed. The drugs of choice, depending on the pathogen, may be Fluconazole, Ketoconazole, Clotrimazole, Terbinafine, Itraconazole, Griseofulvin.

Medications

For most patients with bacterially associated rash without pruritus, the drugs are chosen empirically. More often it is enough to take Dicloxacillin in a dosage of 250 mg orally, or Cephalexin in a dosage of 500 g 4 times a day. Levofloxacin 500 mg once daily or Moxifloxacin 400 mg once daily orally are no less effective. If the patient is allergic to penicillins, it is possible to prescribe Clindamycin 300-450 mg orally three times a day, or macrolides:

• Clarithromycin 250-500 mg orally twice a day;
• Azithromycin 500 mg on the first day, then 250 mg once a day.

Treatment of rash without itching, caused by fungal infection, consists in the use of antifungal agents, which are prescribed in the form of tablets, ointments and creams, solutions for topical application. The duration of the treatment course is determined by a doctor.

In general, a doctor may prescribe the following medications, depending on the cause of the rash without itching:

Hormonal drugs
Triderm	A mixture of the antifungal agent clotrimazole, the corticosteroid betamethasone, and the antibiotic gentamicin. It is prescribed for bacterial or fungal dermatoses sensitive to the action of corticosteroids. It is not recommended for use by women during pregnancy. It is applied to the skin carefully, gently rubbed in, twice a day. Possible adverse reactions: dry skin, local skin changes, endocrine system disorders (with prolonged use).
Flucinar	Ointment with the corticosteroid fluocinolone and the aminoglycoside antibiotic neomycin. It is used for dry dermatoses, especially of allergic nature with secondary infection. It is applied to the skin twice a day, without dressing. Optimal duration of application - no more than 2 weeks (on the skin of the face - no more than one week). For children, apply from 2 years of age, not more than once a day, excluding the face area.
Elocom	Synthetic glucocorticoid drug mometasone. It is prescribed for dermatoses and atopic dermatitis in adults and children over 2 years of age. Standard ointment or cream is applied once a day. Contraindications: acne vulgaris, pyodermitis, diaper dermatitis, parasitic and fungal infections, tuberculosis, syphilis, post-vaccination reactions.
Restorative, healing drugs.
Bepanthen	Used to treat rashes without itching in patients of any age, including children. Among the indications: rashes caused by radiotherapy, phototherapy, ultraviolet radiation, as well as diaper dermatitis. The ointment may be used one or more times a day under a doctor's supervision. Possible side effects: allergy.
Losterol	Complex cream intended for the treatment of various forms of dermatoses and dermatitis, accompanied by dry skin and rashes. The cream is allowed to use as early as 3 months of age, apply a thin layer on the affected skin 2-3 times a day. Side effects in the form of slight burning are noted in very rare cases.
Calming medications for stress rash
Persen	Calming drug on a plant basis, prescribed to adults 2-3 tablets three times a day, regardless of food intake. Side effects: general weakness, dizziness, hypersensitivity reactions.
Novo-Passit	Successfully used in psychosomatic dermatoses in adult patients and children over 12 years of age. Usually take 1 tablet three times a day. The recommended course of treatment is one month. Among possible adverse reactions: drowsiness, allergies, muscle weakness, difficulty breathing.
Anti-allergic agents
Loratadine	Tricyclic antihistamine, prescribed for allergy-related rash without itching. Can be taken from the age of 2 years (dose depends on the weight of the child). Possible side effects: drowsiness, headache, change in appetite, fatigue.
Desloratadine	A 2nd generation antihistamine, used for allergic rash without itching. Adults and children over 12 years of age take 5 mg of desloratadine once a day. In general, the drug in the form of syrup can be used from six months of age according to individually calculated dosages. Adverse reactions are rare: dry mouth, headache, fatigue.
Antifungal ointments
Ketoconazole	Suitable for elimination of rashes without itching caused by dermatophytes, candidiasis. The cream is applied to the skin 1-2 times a day. Use in children has not been studied.
Clotrimazole	Gets rid of rashes provoked by fungal pathogens such as dermatophytes, mold, yeast and dimorphic fungi. The cream is used topically 2 times a day. Possible adverse reactions: allergy.
Antiviral drugs
Acyclovir	Antiviral ointment active against herpes simplex virus types 1 and 2. It is used for the treatment of adults and children over 12 years of age. The ointment is applied every 4 hours, for at least 4 days. Probable side effects: dryness and flaking in the area of application, itching.
Viferon	The ointment contains recombinant human alpha-2b interferon, which provides immunomodulatory, antiviral, antiproliferative effect of the drug. Dosage, duration and frequency of use are determined individually. Possible side effects: itching, allergy.
Zovirax	Cream for the treatment of viral infections of the lips and face caused by herpes simplex virus. Use about 5 times a day, minimally for 4 days. Children are allowed to use the drug from 12 years of age.

In pathologies of the blood and cardiovascular system, it is possible to prescribe drugs that regulate the processes of blood coagulation, hematopoiesis, vascular permeability, heart function. In such situations, the treatment regimen is exclusively individual.

Physiotherapy treatment

Physiotherapy is actively used in the treatment of such pathologies as psoriasis, flat red lichen planus, seborrheic and atopic dermatitis, scleroderma and neurodermatitis, mycoses, herpes, acne, etc. It can be used for general and local treatment. It is possible to use both general and topical treatment.

To stabilize the psycho-emotional state of the patient, sedative procedures are prescribed:

• electrosleep (using pulsed currents by applying electrodes to the head area);
• central electrical stimulation TES (anesthetizes, stabilizes hemodynamic processes, improves tissue regeneration);
• - hydrotherapy (whirlpool baths, bubble massage).

To correct the activity of the parasympathetic nervous system affect the paravertebral ganglia. For this purpose, amplipulsterapy, UHF EP, inductothermia, ultraphonophoresis of prednisolone or hydrocortisone are used.

In order to stimulate adrenal hormonal activity and corticosteroid production, UHF EP is used on the adrenal area, or indirectly transcranially. Under the influence of ultrahigh-frequency electric field the hormone-producing function of pituitary gland is stimulated, which leads to stimulation of adrenal glands and release of corticosteroids into blood, reduction of autoimmune reaction of the organism, inhibition of allergic processes.

Local procedures can inhibit the course of the inflammatory reaction, improve blood circulation, remove inflammatory mediators, reduce the excitation of skin receptors. In this aspect, such types of physiotherapy are relevant:

• TNF (ultrathon therapy) and darsonvalization;
• electrophoresis with anti-allergic agents, galvanization;
• localized magnetotherapy;
• UVO irradiation of the inflamed area;
• laser therapy.

The choice of treatment method depends on individual parameters. Most patients are prescribed a combination of several physiotherapy procedures with both general and local effects.

Contraindications to physical therapy include:

• any new growth in the area of application;
• decompensated conditions;
• the general serious condition of the patient;
• a period of fever;
• acute tuberculosis;
• of psychopathology;
• bullous dermatoses;
• cutaneous porphyria;
• systemic lupus erythematosus;
• hypersensitivity to electric current;
• during pregnancy.

Ultraviolet irradiation is not prescribed to patients with the summer form of psoriasis.

Herbal treatment

Folk therapies can also help with the appearance of a rash without itching. However, their use should always be coordinated with a doctor, as illiterate self-treatment can exacerbate the problem, lead to the spread of the rash, which will require more complex and prolonged treatment.

• A single rash on the back without itching is well eliminated by the use of herbal infusions prepared on the basis of plants with anti-inflammatory and drying effect. Especially popular in this situation are considered calendula and chamomile, which is due to their availability and effectiveness. To prepare a therapeutic infusion, take 1 tbsp. Of crushed flowers, pour 200 ml of boiling water and insist under a lid until it cools down. Then the liquid is strained and used for rinses and lotions three times a day.
• If the rash without itching is caused by infectious processes, then experts advise taking infusions of herbs inside. Among the recommended plants - oregano, which is steamed with boiling water in an enamel cup and insist for half an hour. Warm infusion is taken 20 minutes before eating 1 tbsp. L. Up to five times a day. Not bad anti-inflammatory effect has and sage, which is prepared according to the same principle. Important: herbal remedies should not be taken by women during pregnancy and lactation.
• The juice of celandine or aloe has a drying effect. To obtain a healing remedy, one of these plants is crushed, the resulting pulp is squeezed to obtain juice, which is subsequently applied to the areas covered with a rash without itching.

In general, there are many recipes and ways to use herbs. In any pharmacy there is a wide range of herbal collections, phyto teas, tinctures, etc. However, it should be taken into account that self-medication can be significantly harmful, so any treatment should be coordinated with a doctor.

Surgical treatment

Surgical tactics can be applied to such pathologies:

• furuncles, lymphangitis, swellings, erysipeloid;
• carbuncles, abscesses, phlegmons, hidradenitis;
• necrotizing fasciitis;
• pyomyositis, infectious lesions of muscle cases, clostridial and non-clostridial myonecrosis.

The specifics of treatment of a particular patient are determined during an examination by a surgeon. To clarify the diagnosis, ultrasound diagnostics, X-ray, dermatoscopy, tissue biopsy, and laboratory tests may be prescribed.

Dermatologic interventions may include surgical, radio wave, electrosurgical removal of various neoplasms. Non-contact tissue incision technique ensures optimal and fast healing of the operated area.

In dermatology is often used radiosurgical device Surgitron, which has a number of advantages: minimally damages the tissue, has a sterilization effect, accelerates tissue recovery.

Complications and consequences

To avoid the development of unpleasant consequences of rash complications without itching, it is necessary to remember and adhere to these recommendations:

• Never scratch or squeeze the elements of the rash, do not try to affect them in any other way (mechanical, chemical, etc.);
• don't self-medicate;
• don't open any blisters or pustules;
• Do not use aggressive external agents, do not apply to the area of rashes coloring solutions (brilliant green, fucorcin), so as not to distort the picture that will later be seen by a doctor.

Unfortunately, a rash without itching is not always noticed in time, especially if it is not accompanied by other clinical symptoms. Meanwhile, this sign is not always harmless: depending on the root cause, rashes can be one of the manifestations of dangerous and even serious diseases.

• Complications of measles can include pneumonia, otitis media, and sometimes encephalitis.
• Complications of epidparotitis - inflammation in glandular organs, development of viral meningitis.
• Urticaria can be complicated by Quincke's edema - a severe condition accompanied by bronchospasm, shortness of breath and other rapidly increasing symptoms that can be fatal if not treated.
• Complications of meningococcemia are infectious toxic shock and multiorgan failure. In severe cases, there is always a pronounced DIC syndrome.

In general, a rash without itching does not pose a direct threat to the patient's life. However, the development of complications of varying degrees of severity may be associated with the primary disease.

Prevention

Prevention of the appearance of rashes without itching is to eliminate possible causes of this phenomenon.

If a person is prone to allergies, they should:

• always avoid contact with potential allergens and unknown substances;
• comply with the doctor's recommendations regarding the use of certain foods (if necessary, you should follow a special diet);
• take prescribed anti-allergy medications.

You can prevent a rash without itching of infectious origin by:

• Regularly observe all hygiene and sanitation rules;
• avoid contact with sick people;
• exclude staying in crowded areas, which is especially important during periods of exacerbation of infectious diseases (epidemics);
• get immunized in a timely manner;
• avoid using other people's hygiene products, clothing, etc;
• regularly wet clean and ventilate the room;
• Eat a nutritious diet, make sure that the diet contains the necessary vitamins, minerals, as well as the balance of proteins-fats-carbohydrates.

It is important to visit your doctor regularly, both for preventive check-ups and to treat any illnesses at the first sign of them.

Forecast

Determining the cause and further treatment of a rash without itching always takes time. Therefore, the patient must be patient and carefully follow all the doctor's instructions. Moreover, the treatment process can proceed with alternating relapses and remissions, which is associated with the origin of the pathology and the peculiarities of its course. However, in most cases, the cause of the problem is found and successfully eliminated.

Infectious-inflammatory processes in the area of the skin regress relatively quickly against the background of timely antibacterial therapy. In the absence of treatment, the development of necrotizing subcutaneous processes, bacteremia with the spread of infectious foci is possible. Often there are exacerbations.

In the absence of timely therapy, a rash without itching can worsen, acquire a widespread course.