Rash without itching

On the skin of a person, many reactions and processes that occur inside the body are displayed. Therefore, there is nothing strange in the fact that various kinds of rashes periodically appear on the skin. And this is not only a cosmetic problem: a rash without itching can be the “first bell” for the development of an infectious, toxic or other pathology. Therefore, this symptom cannot be ignored: you should consult a doctor, diagnose, find the cause of the violation and eliminate it.

Causes of the rash without itching

A rash without itching in the form of spots, vesicles, nodules, pimples, etc., can occur under the influence of physical, chemical and other factors. Immediate causes may be:

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

Consider the most common causes of a rash 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, therefore, upon contact with the infection, all unvaccinated and previously unill people fall ill. [1]
• Rubella is a viral infectious disease that can be congenital or acquired. The acquired disease is transported by airborne droplets, is often accompanied by moderate symptoms and has a favorable prognosis. Congenital rubella is transmitted from mother to unborn baby through the placental layer and causes the formation of severe developmental defects. The greatest danger is rubella in a woman who is in the first trimester of pregnancy, during the laying of the main organs and systems of the child. [2]
• Scarlet fever is an infectious disease caused by group A B-hemolytic streptococcus. In addition to scarlet fever, this bacterium causes the development of pathologies such as erysipelas, streptoderma, and streptococcal tonsillitis. Method of transmission of infection: airborne and contact-household. [3]
• Pseudotuberculosis (yersiniosis) is a bacterial infection caused by the causative agent Yersinia tuberculosis (pseudotuberculosis stick). The symptomatology of the disease is usually represented by toxic-allergic signs, a scarlet fever-like rash, and pathological manifestations of the digestive system. The source of infection are rodents: mice, rats. Infection of a person is possible by eating products infected with the excrement of sick animals. [4]
• Intestinal yersiniosis is an acute infection caused by Yersinia enterocolitica. Probable source of infection: a sick person, rodents, soil. Infection occurs by eating infected meat, fish, milk, vegetables and fruits, by drinking raw water, by contact with sick animals. The disease affects the digestive system, liver, joints, 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 (the use of antibiotics, local anesthetics, etc.);
• inhalation;
• provoked by insect bites;
• caused by malignant processes;
• due to hormonal changes (in particular, during pregnancy);
• autoimmune;
• caused by genetic pathologies.

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

• meningococcemia - a generalized form of meningococcal infection, which is characterized by a 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 limbs, oropharynx, tongue, respiratory failure and depression of consciousness. [7]

In such cases, an ambulance should be called immediately.

Risk factors

Risk groups for the appearance of various kinds of rashes without itching include:

• people prone to increased sweating, sebum secretion;
• persons with weakened immune defenses (for example, patients undergoing chemotherapy or treatment with glucocorticosteroids);
• people who often visit public places (gyms, swimming pools, etc.);
• preferring clothes and shoes made of synthetic materials with insufficient ventilation;
• neglecting the recommendations for personal hygiene, using other people's towels, shoes, bedding and underwear;
• patients who have recently suffered from infectious and inflammatory processes, who have undergone a course of antibiotic therapy;
• living in endemic unsafe areas;
• working in conditions of high humidity, temperature;
• obese, diabetic, HIV-infected people.

Pathogenesis

The skin is the largest human organ. They perform the most important functions for the body: they provide metabolism, thermoregulation, protection, and receptor ability. The skin is made up of the following layers:

• the epidermal, outer layer, which in turn is represented by five layers, providing mainly barrier protection;
• the dermal layer of connective tissue, localized between the epidermis and lower organs, from which the dermis is separated by subcutaneous tissue;
• subcutaneous tissue is 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. Its thickness varies. The water-fat mantle covers the stratum corneum, enhancing the protective properties. It maintains a certain level of acidity, which is normally 4.5-5.5. In many skin diseases like a rash without itching (mycoses, acne), the acidity index changes.

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

With infectious lesions, the mechanism for the development of pathological rashes is somewhat different. In particular, with scarlet fever, the infectious agent produces an 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 cell infiltration. By the way, in the elements of rashes with measles there is always a pathogen.

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

Epidemiology

A rash without itching most often worries owners of excessively dry or, conversely, oily skin prone to acne, vascular defects, hyperpigmentation and other external manifestations. Common diseases, enlarged pores, acne, etc. Precede the appearance of rashes. Teenagers and patients suffering from endocrine or digestive pathologies often experience such symptoms.

Even on outwardly perfect skin, a rash without itching may appear, which can be associated with hormonal changes, stress, unfavorable environmental conditions and other factors that negatively affect the body. Problematic skin is the most prone to breakouts.

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

The highest frequency of infectious pathologies is observed in early childhood. In accordance with this, an infectious rash without itching is more common in pediatrics, in preschool children.

Symptoms

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

• Spots - are elements that are imperceptible to palpation with a diameter of less than 1 cm. In fact, these are just limited areas of color change that do not rise or fall when compared with the surrounding tissue.
• Papules are protruding elements of the rash that can be felt, with a diametrical size of up to 1 cm.
• Plaques are rashes that can be felt, as they rise or fall in comparison with the surrounding cover. The plaques are round or flat.
• Nodules are indurated papules or rash without itching, extending into the dermal or subcutaneous fat layer.
• Vesicles or vesicles are cavitary rashes, inside of which there is a clear liquid. The elements are small (less than 1 cm), transparent. If the dimensions exceed 1 cm, then they are called bubbles.
• Pustules are the same vesicles, but with purulent contents. Their appearance is often due to bacterial infections and inflammatory diseases.
• Urticaria is a raised rash without itching or with itching, which occurs as a result of local swelling. Otherwise, such rashes are called blisters.
• Scales are areas of accumulation of particles of the horny 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, platelet 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 the disease is characterized by certain first signs, for example:

• With measles, intoxication symptoms are pronounced: the temperature rises, pains appear in the head, joints, and muscles. Further, catarrhal symptoms are added (cough, itching in the nose, runny nose, lacrimation, photophobia). The rash is found on the third day: first in the face and neck, then on the shoulders, chest, abdomen, back, limbs. A rash on the face without itching, with a tendency to spread "from top to bottom" is a characteristic sign of measles. It is possible to change the rashes with pigmentation spots, which persist for several weeks. The mucous membranes are also covered with small whitish spots, which is especially noticeable on the inner surface of the cheeks. [8], [9] 
• With rubella, an acute onset is observed: the temperature rises slightly, moderate catarrhal symptoms are noted, the lymph nodes increase and become painful. Rashes also appear almost immediately. At first it is a rash without itching on the chest, then it spreads to the stomach and other parts of the body, including the limbs, face, back. The vast majority of lesions remain localized in the chest area. The elements of the rash are dull, pale pinkish in color. [10]
• With scarlet fever, there is a symptomatic triad: skin rash, fever, and severe reddening of the throat with the appearance of pus in the gaps. The onset of the disease is acute. A rash without itching is small-pointed, occurs within a few hours from the start of the pathology and quickly (within a couple of hours) spreads throughout the body, starting from the face to the neck, chest, abdomen, limbs. A characteristic feature: when the palm is lightly passed over the surface of the skin, pronounced dryness and roughness are felt, as if the body is covered with "goosebumps". The submandibular lymph nodes increase, the tongue first becomes whitish (with a coating), then - bright crimson, smoothed. [11]
• With pseudotuberculosis, the temperature first rises sharply, abdominal pain and nausea appear, and the temperature rises. Perhaps an increase in the liver and spleen, pain in the joints, diarrhea. A rash without itching is found throughout the body: it is reddish-cyanotic, small-pointed (reminiscent of that of scarlet fever), more pronounced in areas of natural skin folds, prone to fusion. Other characteristic signs: a pale nasolabial triangle, a symptom of "gloves" (rash on the hands without itching), "socks" (rash on the feet), or "hood" (rash on the neck, face and shoulder girdle). The skin is dry, rough. The throat area is red, inflamed, but there is no purulent tonsillitis. [12]
• With intestinal yersiniosis, an acute onset is noted: the patient complains of general weakness, abdominal pain, nausea, and diarrhea. The rash without itching resembles that of measles. It is localized mainly in the skin folds, on the sides of the body, in the joints. Pain in the head, throat, muscles and joints, nasal congestion may also be disturbing. Sometimes the lymph nodes and liver are enlarged. [13]
• With non-communicable diseases, different types of rashes on the legs may appear without itching. More often these 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 coalesce and form large irregularly shaped lesions.

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

• what kind of rash without itching (color shade, size);
• its localization, profusion;
• possible connection with any event or contact;
• accompanying symptoms.

A rash without itching is different, and the patient himself will not always be able to determine its origin. Therefore, you should definitely 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 types of rash in adults without itching due to coronavirus infection have been noted:

• Unsymmetrical spots, resembling a frostbite reaction, in the arms and legs, sometimes painful when touched. A similar rash without itching and temperature was observed mainly in patients with a mild course of the disease and passed on its own after about 12 days. The frequency of occurrence of the symptom is about 19%.
• Lumpy, transient rash without itching, which looks like small blisters located on the body and limbs. The symptom appears simultaneously with other pathological signs and persists for about 10 days.
• Rash on the abdomen without itching, superficially resembling urticaria, with a pinkish or whitish tint. Less common in the limbs and palms.
• Maculopapular rashes that look like flattened or protruding vesicles, with a frequency of occurrence of about 47%. The duration of the existence of such elements is about 7 days, more often against the background of a severe course of coronavirus infection.
• Small rash without itching in the form of a bluish-red vascular network. It is observed 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.

Rash without itching in a child

A small reddish rash without itching is the most common type of rash that is found in children of early, preschool and primary school age. Small points without purulent contents 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 improper hygiene. The consequence of neglecting hygiene is diaper rash, prickly heat. In infants, a rash without itching often appears on the head, since it is through the skin of the head that thermoregulation occurs in babies.

A rash without itching also occurs with certain diseases of a viral and microbial nature, with scarlet fever, measles, and leukemia. A watery rash in most cases becomes a symptom of herpetic and pustular infections, allergic processes, insect bites and ultraviolet exposure.

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

Purulent rashes are more typical for 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 child's skin? First of all, you need to take a good look at the baby's skin, determine the type of rashes, their size and other features. It is important to remember and analyze what could have caused the problem. Next, you should measure the temperature, examine the throat, tonsils, and then go with the child to the clinic or, if necessary, call the doctor at home (for example, if the baby is presumably contagious). It is categorically impossible to prescribe treatment for children on their own. [14]

Diagnostics of the rash without itching

The treatment of a rash without itching is started only after determining the actual cause of its occurrence. The wrong treatment approach can exacerbate the problem. The type of treatment completely depends on what served as a provoking factor in the occurrence of rashes.

What can be used for diagnosis:

• taking scrapings from the skin;
• removal of samples of the contents of vesicles and pustules;
• collection of blood, urine and stool samples.

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

Appropriate tests are prescribed for suspected infectious and allergic diseases:

• detection of class M immunoglobulins (measles, antibodies to the IgM virus);
• determination of a marker of immune memory to rubella, identification of primary rubella infection;
• determination of the marker of sensitization of the body to streptococcal antigens, bacteriological culture and antibiogram of the biomaterial from the tonsils in case of suspected scarlet fever;
• screening for inhalation, mixed, drug, food allergies;
• determination of the DNA of the causative agent of a fungal infection by PCR;
• determination of IgG antibodies to pathogens of fungal infections.

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

Instrumental diagnostics can be represented by such studies:

• radiography (helps to assess the amount of affected tissue - for example, with respiratory infections);
• ultrasound examination (helps to visualize internal organs, detect pathological neoplasms);
• computed tomography (allows you to examine the affected internal organs in layers).

Differential diagnosis

The characteristic of a rash without itching has a 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 presented in the table:

Measles	Spotted-papular rash without itching, prone to fusion, appearing in stages: on the first day - in the face, neck, upper thoracic segment and shoulder girdle; on the second day - the body is completely covered with rashes, spreading to the upper limbs; on the third or fourth day - with spread to the lower limbs. The confluence of the rash in the face leads to its puffiness, thickening of the eyelids, coarsening of facial features, and a pronounced change in appearance.
Scarlet fever	A small dotted rash without itching appears on the first or second day of the disease, localized on the reddened areas of the neck, upper thoracic segment, and back. During the day, it spreads to the whole body. There is an accumulation of rashes in the area of skin folds (neck, armpits, groin, popliteal fossae, etc.).
Rubella	A rash without itching occurs within 24-48 hours from the onset of the disease. Spreads rapidly to face, chest, abdomen, back, arms and legs. Rashes are small-spotted, the elements have even configurations, pale pinkish, plentiful. The spots do not rise above the surface of the skin, turn pale when pressed. The accumulation of spots is observed in the extension of the limbs, as well as on the back and buttocks. The background of the rash is normal skin. The rash without itching does not leave pigmentation and disappears within 2-4 days.
Pseudotuberculosis	A rash without itching occurs on the first or second day of the disease, at the same time, more often - like scarlet fever (small dot). The color range is from pale pinkish to bright purple-cyanotic. The skin background also varies. Localization is symmetrical. In some cases, itching may be present. The rash disappears within 24 to 144 hours.
Enteroviral infection	A rash without itching occurs at one moment, against the background of unchanged skin. Main elements: spots, papules, small dots, hemorrhages. Pass without a trace for 24-48 hours.
Meningococcemia	Rash without itching appears in the initial 24 hours of illness. Differs in variety and different sizes: the elements are represented by spots, papules, hemorrhages, "asterisks" of irregular configuration with a seal in the center. The nature of the rashes is gradual, with increasing dynamics. Dominant location: buttocks, legs. The skin background is unchanged. In process of disappearance in some places of intensive rashes areas of a necrosis are formed.
Typhoid fever	Roseolas are present in the form of pinkish spots with a diameter of about 2-3 mm, which turn pale when pressed. They appear on the 8-10th day of the disease, they are prone to periodic falling asleep. Disappear without a trace after 24-120 hours.
Herpetic infection	A local rash is noted on a limited area of the skin, on which pain, burning, redness first appear, and only then - vesicles with serous contents. The skin is edematous, reddened. After opening, weeping erosions are found, covered with crusts, followed by epithelialization. Primary localization: lip border, nose, cheeks or forehead, buttocks and thighs, forearms, hands.

Treatment of the rash without itching

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

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

In an allergic process, for example, treatment begins with the cessation of the action of the allergen, after which the medical elimination of directly pathological signs is carried out with the help of antihistamines and other drugs. It is recommended to take medications such as Loratadin, Desloratadine, Diazolin, Suprastin. In difficult 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 complex therapy. These can be antibiotics, sorbent and detoxification drugs, antiviral agents, immunoglobulins, etc. In particular, patients with bacterial dermatitis of a staphylococcal or streptococcal nature are unambiguously prescribed antibiotics with a wide spectrum of antimicrobial activity. Macrolide preparations (Azithromycin) are recommended, and Ceftriaxone is often prescribed. Most patients with pyoderma report improvement after regular treatment of rash areas 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 body's immune response and contribute to the rapid relief of clinical signs of the disease.

If the rash without itching is due to a violation of sweating, then it is recommended to carefully observe the rules of personal hygiene, wear clothes and shoes made only from natural high-quality materials, and 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 directed antimycotic action is prescribed. The drugs of choice, depending on the causative agent of the pathology, can be Fluconazole, Ketoconazole, Clotrimazole, Terbinafine, Itraconazole, Griseofulvin.

Medications

For most patients with bacterial rash without pruritus, drugs are selected empirically. More often, it is enough to take Dicloxacillin at a dosage of 250 mg orally, or Cefalexin at a dosage of 500 g 4 times a day. Equally effective are Levofloxacin 500 mg once a day or Moxifloxacin 400 mg once a day orally. If the patient is allergic to penicillins, then 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 a rash without itching caused by a 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 the doctor.

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

Hormonal drugs
Triderm	A mixture of the antifungal agent clotrimazole, the corticosteroid betamethasone, the antibiotic gentamicin. It is prescribed for bacterial or fungal dermatoses sensitive to the action of corticosteroids. Not recommended for use by women during pregnancy. Apply to the skin gently, rubbing gently, twice a day. Possible adverse reactions: dry skin, local skin changes, disorders of the endocrine system (with prolonged use).
Flucinar	Ointment with corticosteroid fluocinolone and aminoglycoside antibiotic neomycin. It is used for dry dermatosis, especially of an allergic nature with the addition of secondary infection. It is applied to the skin twice a day, without a bandage. The optimal duration of application is no more than 2 weeks (on the skin of the face - no more than one week). Children are used from 2 years old, no more than once a day, excluding the face area.
Elokom	Synthetic glucocorticoid drug mometasone. It is prescribed for dermatoses and atopic dermatitis for adults and children over 2 years old. Typically, the ointment or cream is applied once a day. Contraindications: acne vulgaris, pyodermatitis, diaper dermatitis, parasitic and fungal infections, tuberculosis, syphilis, post-vaccination reactions.
Restorative, healing preparations
Bepanthen	Used to eliminate rashes without itching in patients of any age, including children. Among the indications: rash caused by radiotherapy, phototherapy, ultraviolet radiation, as well as diaper dermatitis. The ointment can be used once or several times a day under medical supervision. Possible side effects: Allergy.
Losterin	A complex cream intended for the treatment of various forms of dermatosis and dermatitis, accompanied by dry skin and rash. The cream is allowed to be used already from the age of 3 months, applied in a thin layer on the affected skin 2-3 times a day. Side effects in the form of a slight burning sensation are noted in very rare cases.
Sedatives for stress rashes
Persen	A sedative herbal preparation is prescribed for adults 2-3 tablets three times a day, regardless of the meal. Side effects: general weakness, dizziness, hypersensitivity reactions.
Novo-Passit	It has been 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 the possible adverse reactions: drowsiness, allergies, muscle weakness, difficulty breathing.
Antiallergic drugs
Loratadine	Tricyclic antihistamine, prescribed for allergic-caused rash without itching. Can be taken from 2 years of age (the dose depends on the weight of the child). Possible side effects: drowsiness, headache, change in appetite, fatigue.
Desloratadine	Antihistamine of the 2nd generation, used for allergic rashes without itching. Adults and children over 12 years of age take 5 mg of desloratadine once daily. In general, the preparation in the form of a syrup can be used from the age of six months according to individually calculated dosages. Adverse reactions are rare: dry mouth, headache, fatigue.
Antifungal ointments
Ketoconazole	Suitable for eliminating 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	Relieves rashes caused by fungal pathogens such as dermatophytes, moulds, yeasts and dimorphic fungi. The cream is used topically 2 times a day. Possible adverse reactions: Allergy.
Antivirals
Acyclovir	Antiviral ointment active against herpes simplex virus types 1 and 2. It is used to treat adults and children over 12 years of age. The ointment is applied every 4 hours for at least 4 days. Possible side effects: dryness and peeling in the area of application, itching.
Viferon	The ointment contains recombinant human alpha-2b interferon, which provides immunomodulatory, antiviral, antiproliferative effects of the drug. Dosage, duration and frequency of use are determined individually. Possible side effects: itching, allergies.
Zovirax	Cream for the treatment of viral infections of the lips and face caused by the herpes simplex virus. Use about 5 times a day, at least for 4 days. Children are allowed to use the drug from the age of 12.

With pathologies of the blood and the cardiovascular system, it is possible to prescribe drugs that regulate blood coagulation, hematopoiesis, vascular permeability, and 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, lichen planus, seborrheic and atopic dermatitis, scleroderma and neurodermatitis, fungal infections, herpes, acne, etc. Both general and local effects can be used.

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

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

To correct the activity of the parasympathetic nervous system, the paravertebral ganglia are affected. For this purpose, amplipulse therapy, UHF EP, inductothermy, ultraphonophoresis of prednisolone or hydrocortisone are used.

In order to stimulate the hormonal activity of the adrenal glands and the production of corticosteroids, UHF EP is used on the adrenal zone, or indirectly transcranially. Under the influence of an ultra-high-frequency electric field, the hormone-producing function of the pituitary gland is stimulated, which leads to stimulation of the adrenal glands and the release of corticosteroids into the blood, to a decrease in the autoimmune reaction of the body, and suppression of allergic processes.

Local procedures allow you to slow down the course of the inflammatory reaction, improve blood circulation, remove inflammatory mediators, and reduce the excitation of skin receptors. In this aspect, the following types of physiotherapy are relevant:

• TNF therapy (ultratone therapy) and darsonvalization;
• electrophoresis with antiallergic agents, galvanization;
• magnetotherapy of local influence;
• UV irradiation of the inflamed area;
• laser therapy.

The choice of treatment technique depends on individual indicators. Most patients are prescribed a combination of several physiotherapy procedures, both general and local.

Contraindications to physiotherapy are:

• any neoplasms in the area of application;
• decompensated states;
• the general serious condition of the patient;
• fever period;
• acute form of tuberculosis;
• psychopathology;
• bullous dermatoses;
• cutaneous porphyria;
• systemic lupus erythematosus;
• hypersensitivity to electric current;
• period of pregnancy.

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

Herbal treatment

Alternative therapies can also help with a non-itchy rash. However, their use should always be agreed with the doctor, since illiterate self-medication can aggravate the problem, lead to the spread of a rash, which will require more complex and lengthy treatment in the future.

• 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 effects. Especially popular in this situation are calendula and chamomile, due to their availability and effectiveness. To prepare a medicinal infusion, take 1 tbsp. L. Crushed flowers, pour 200 ml of boiling water and insist under the lid until cool. Then the liquid is filtered and used for washings and lotions three times a day.
• If a rash without itching is caused by infectious processes, then experts advise taking infusions of medicinal herbs inside. Among the recommended plants is oregano, which is steamed with boiling water in an enamel mug and infused for half an hour. Warm infusion is taken 20 minutes before meals, 1 tbsp. L. Up to five times a day. Sage, which is prepared according to the same principle, also has a good anti-inflammatory effect. Important: herbal preparations should not be taken by women during pregnancy and lactation.
• Celandine juice or aloe have a drying effect. To obtain a healing agent, one of these plants is crushed, the resulting slurry is squeezed out to obtain juice, which is subsequently applied to areas covered with a rash without itching.

In general, there are many recipes and ways to use herbs. Any pharmacy has a wide range of herbal preparations, herbal teas, tinctures, etc. And yet, it must be taken into account that self-medication can do much harm, so any type of treatment should be agreed with the doctor.

Surgery

Surgical tactics can be applied in relation to such pathologies:

• boils, lymphangitis, erysipelas, erysipeloid;
• carbuncles, abscesses, phlegmon, hydradenitis;
• necrotizing fasciitis;
• pyomyositis, infectious lesions of the muscular sheaths, clostridial and non-clostridial myonecrosis.

Features of the treatment of a particular patient are determined during the examination by a surgeon. To clarify the diagnosis, it is possible to prescribe ultrasound diagnostics, x-rays, dermatoscopy, tissue biopsies, as well as laboratory tests.

Dermatological interventions may include surgical, radio wave, electrosurgical removal of various neoplasms. The non-contact tissue incision technique ensures optimal and rapid healing of the operated area.

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

Complications and consequences

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

• in no case comb or squeeze out the elements of the rash, do not try to act on them in any other way (mechanical, chemical, etc.);
• do not engage in self-treatment;
• do not open blisters and pustules;
• do not use aggressive external agents, do not apply coloring solutions (brilliant green, fucorcin) to the area of \u200b\u200brashes, so as not to distort the picture that the doctor will see later.

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

• A complication of measles can be pneumonia, otitis media, and sometimes encephalitis.
• Complications of epidparotitis - inflammation in the glandular organs, the development of viral meningitis.
• Urticaria can be complicated by Quincke's edema, a serious condition accompanied by bronchospasm, shortness of breath and other rapidly increasing symptoms, which, if left untreated, can lead to death.
• Complications of meningococcemia are infectious-toxic shock and multiple organ failure. In severe cases, there is always a pronounced DIC.

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

Prevention

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

If a person has a tendency to allergies, then he should:

• always exclude contact with potential allergens and unknown substances;
• follow medical recommendations regarding the use of certain foods (if necessary, you should follow a special diet);
• take prescribed antiallergic medications.

You can prevent a rash without itching of an infectious origin if:

• regularly comply with all sanitary and hygienic rules;
• avoid contact with sick people;
• exclude staying in areas of large concentrations of people, which is especially important for periods of exacerbation of infectious diseases (epidemics);
• be vaccinated in a timely manner;
• exclude the use of other people's hygiene products, clothing, etc.;
• regularly carry out wet cleaning and ventilate the room;
• eat fully, monitor the presence in the diet of the necessary vitamins, minerals, as well as the balance of proteins-fats-carbohydrates.

It is important to regularly visit a doctor, both for the purpose of preventive examination and for the treatment of any diseases when their first signs appear.

Forecast

Determining the cause and further treatment of a rash without itching always requires a certain amount of 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 characteristics of its course. However, in most cases, the cause of the problem is found and successfully eliminated.

Infectious and inflammatory processes in the area of the skin regress relatively quickly against the background of timely antibiotic 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, become widespread.