A rash without itching

The human skin reflects many reactions and processes that occur inside the body. 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" of the development of an infectious, toxic or other pathology. Therefore, this symptom cannot be ignored: you should consult a doctor, conduct diagnostics, find the cause of the disorder and eliminate it.

Causes itchless rash

A rash without itching in the form of spots, blisters, nodules, pimples, etc., can occur under the influence of physical, chemical and other factors. The immediate causes can 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, side effect of drug therapy.

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

• Measles is an infectious disease that is transmitted by airborne droplets from a sick person infected with the measles virus. The virus is highly contagious, so when in contact with the infection, all unvaccinated and previously uninfected people become ill. [ 1 ]
• Rubella is a viral infectious disease that can be congenital or acquired. The acquired disease is transmitted by airborne droplets, is often accompanied by moderate symptoms and has a favorable prognosis. Congenital rubella is transmitted from mother to unborn child through the placental layer and causes severe developmental defects. Rubella is most dangerous for a woman in the first trimester of pregnancy, during the period of laying 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 such pathologies as erysipelas, streptoderma, streptococcal sore throat. The method of transmission of infection: airborne and contact-household. [ 3 ]
• Pseudotuberculosis (yersiniosis) is a bacterial infection caused by the pathogen Yersinia tuberculosis (pseudo-tuberculosis bacillus). Symptoms of the disease are usually toxic-allergic signs, scarlet fever-like rash, and pathological manifestations of the digestive system. The source of infection is rodents: mice, rats. Human infection is possible by eating foods contaminated with the excrement of sick animals. [ 4 ]
• Intestinal yersiniosis is an acute infection caused by Yersinia enterocolitica. The probable source of infection is a sick person, rodents, soil. Infection occurs when eating contaminated meat, fish, milk, vegetables and fruits, when drinking raw water, when in contact with sick 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, compression);
• contact (water, cosmetics and household chemicals, latex products, etc.);
• food (hypersensitivity to certain foods);
• medicinal (use of antibiotics, local anesthetics, etc.);
• inhalation;
• caused by insect bites;
• caused by malignant processes;
• caused by hormonal changes (in particular, during pregnancy);
• autoimmune;
• caused by genetic pathologies.

A rash without itching can also be a sign of a life-threatening pathology, for example:

• meningococcemia - a generalized form of meningococcal infection, 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 extremities, oropharynx, tongue, difficulty breathing and decreased consciousness. [ 7 ]

In such cases, you should call an ambulance immediately.

Risk factors

Risk groups for the development of various types of rashes without itching include:

• people prone to increased sweating and sebum secretion;
• people with weakened immune systems (for example, patients undergoing chemotherapy or treatment with glucocorticosteroids);
• people who frequently visit public places (gyms, swimming pools, etc.);
• those who prefer clothing and footwear made from synthetic materials that lack adequate ventilation;
• neglecting personal hygiene recommendations, using other people’s towels, shoes, bed linen and underwear;
• patients who have recently suffered from infectious and inflammatory processes and have undergone a course of antibiotic therapy;
• living in endemically unsafe areas;
• working in conditions of high humidity and temperature;
• people suffering from obesity, diabetes, and HIV-infected people.

Pathogenesis

The skin is the largest organ of the human body. It performs the most important functions for the body: it provides metabolism, thermoregulation, protection, and receptor capacity. The skin consists 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 located between the epidermis and the underlying organs, from which the dermis is separated by subcutaneous tissue;
• subcutaneous tissue, represented by a loose connective tissue structure containing fatty inclusions.

The stratum corneum provides protection: it is devoid of living structures and includes only dead cells. Its thickness varies. The hydrolipid mantle covers the stratum corneum, enhancing its protective properties. It maintains a certain level of acidity, which is normally 4.5-5.5. With many skin diseases such as rashes without itching (mycosis, acne), the acidity index changes.

The hydrolipid mantle has its own microflora. It can be represented by multiple symbiosis of microorganisms, including such as fungi, epidermal staphylococcus, etc. Such microorganisms ensure the constancy of the acidic environment on the skin and prevent 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 this can affect the appearance of a rash without itching.

In infectious lesions, the mechanism of development of pathological rashes is somewhat different. In particular, in 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, caused by viral damage to the vascular endothelium, perivascular exudation and cellular infiltration. By the way, the pathogen is always present in the elements of the rash in measles.

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 also not excluded.

Epidemiology

A rash without itching most often bothers those with excessively dry or, conversely, oily skin prone to acne, vascular defects, hyperpigmentation and other external manifestations. The appearance of rashes is preceded by general diseases, enlarged pores, acne, etc. Teenagers and patients suffering from endocrine or digestive pathologies often encounter such symptoms.

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

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 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. Accordingly, infection-induced rash without itching is more common in pediatrics, in preschool children.

Symptoms

Non-itchy rashes can vary depending on the type of lesion:

• Spots are elements that are less than 1 cm in diameter and imperceptible to palpation. In essence, these are simply limited areas of color change that do not rise or fall when compared to the surrounding tissue.
• Papules are protruding elements of the rash that can be felt, with diameters 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 round or flat.
• Nodules are firm, non-itchy papules or rashes that extend into the dermal or subcutaneous fat layer.
• Vesicles are cystic rashes that contain a clear liquid. The elements are small (less than 1 cm) and transparent. If the size exceeds 1 cm, they are called blisters.
• Pustules are the same bubbles, but with purulent contents. Their appearance is often caused by bacterial infections and inflammatory diseases.
• Hives are raised rashes with or without itching that occur as a result of localized swelling. They are also called wheals.
• Scales are areas of accumulation of particles of horny epithelium, which is especially characteristic of mycoses and psoriasis.
• Petechiae are small hemorrhages that do not fade or disappear when pressed with a finger. Such rashes are typical for meningococcemia, thrombocytic pathologies, vasculitis, etc.
• Telangiectasias are small areas of dilated blood vessels that occur in 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, the intoxication symptoms are pronounced: the temperature rises, there are pains in the head, joints, muscles. Then catarrhal symptoms are added (cough, itching in the nose, 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. A rash on the face without itching, with a tendency to spread "from top to bottom" is a characteristic sign of measles. The rash may be replaced by pigmentation spots, which persist for several weeks. The mucous membranes are also covered with small whitish spots, which are especially noticeable on the inner surface of the cheeks. [ 8 ], [ 9 ]
• Rubella has an acute onset: the temperature rises slightly, moderate catarrhal symptoms are noted, the lymph nodes enlarge and become painful. The rash also appears almost immediately. At first, it is a rash without itching on the chest, then spreads to the abdomen and other parts of the body, including the limbs, face, and back. The overwhelming majority of the rash remains localized in the chest area. The rash elements are dull, pale pinkish in color. [ 10 ]
• Scarlet fever is characterized by a symptomatic triad: skin rash, fever, and severe redness of the throat with pus appearing in the lacunae. The onset of the disease is acute. The rash is non-itchy, fine-pointed, and appears within a few hours of the onset of the pathology and quickly (within a couple of hours) spreads throughout the body, starting from the face to the neck, chest, abdomen, and limbs. A characteristic symptom: when lightly running the palm over the surface of the skin, a pronounced dryness and roughness is felt, as if the body is covered in "goosebumps." The submandibular lymph nodes enlarge, the tongue first becomes whitish (with a coating), then bright crimson, smoothed. [ 11 ]
• With pseudo-tuberculosis, the temperature initially rises sharply, abdominal pain and nausea appear, and the temperature rises. The liver and spleen may enlarge, joint pain, and diarrhea may occur. A rash without itching is found all over the body: it is reddish-bluish, finely punctate (resembling that of scarlet fever), more pronounced in areas of natural skin folds, and tends to merge. Other characteristic signs: a pale nasolabial triangle, the "glove" symptom (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 and rough. The pharynx is red and inflamed, but there is no purulent tonsillitis. [ 12 ]
• Intestinal yersiniosis has an acute onset: the patient complains of general weakness, abdominal pain, nausea, and diarrhea. The rash without itching resembles that of measles. It is localized mainly in skin folds, on the sides of the body, and in the area of joints. Headache, throat pain, muscle and joint pain, and nasal congestion may also be a concern. Sometimes the lymph nodes and liver enlarge. [ 13 ]
• In non-infectious diseases, different types of rashes on the legs without itching may appear. Most 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 merge and form large lesions of irregular configuration.

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

• what type of rash without itching is it (color, size);
• its localization, abundance;
• possible connection with some event or contact;
• accompanying symptoms.

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

A red rash without itching is also typical for viral diseases, including COVID-19. Such rashes do not depend on the severity of the infectious process and can appear even in patients with an asymptomatic course of the disease. The following types of rashes in adults without itching caused by coronavirus infection have been noted:

• Asymmetrical spots resembling a frostbite reaction on the arms and legs, sometimes painful to the touch. Such a rash without itching and fever 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%.
• A focal, transient rash without itching, in the form of small blisters located on the body and limbs. The symptom appears simultaneously with other pathological signs and persists for about 10 days.
• A rash on the abdomen without itching, resembling hives, with a pinkish or whitish tint. Less common on the limbs and palms.
• Maculopapular rashes, which look like flattened or protruding vesicles, with a frequency of occurrence of about 47%. The duration of existence of such elements is about 7 days, more often against the background of a severe course of coronavirus infection.
• A small, non-itchy rash 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.

Non-itchy rash 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 dots without purulent contents sometimes appear in the head, armpits, shoulder girdle, abdomen and back, perineum. Such a rash is typical for allergic reactions, but often occurs as a result of overheating and improper hygiene. Neglect of hygiene results in diaper rash, prickly heat. In infants, a rash without itching often appears on the head, since it is through the scalp that babies thermoregulate.

A rash without itching also occurs with certain diseases of viral and microbial origin, with scarlet fever, measles, 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 caused by Staphylococcus aureus.

What should parents do if they see a rash without itching on their child's skin? First of all, you need to take a good look at the baby's skin, determine the type of rash, its 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 take the child to the clinic or, if necessary, call a doctor to the house (for example, if the baby is suspected of being contagious). It is strictly forbidden to prescribe treatment for children on your own. [ 14 ]

Diagnostics itchless rash

Treatment of a rash without itching is started only after determining the actual cause of its appearance. An incorrect treatment approach can cause the problem to worsen. The type of treatment depends entirely on what served as the provoking factor for the appearance of the rash.

What can be used for diagnostics:

• 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 with an allergist, infectious disease specialist, pediatrician, gastroenterologist, endocrinologist and other specialists is prescribed.

The corresponding tests are prescribed if infectious and allergic diseases are suspected:

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

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

Instrumental diagnostics can be represented by the following studies:

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

Differential diagnosis

The characteristics of a rash without itching have differential diagnostic significance: it is important to note the period of occurrence, dynamics, sequence of appearance, localization, distribution, and duration of the rash.

The main diagnostic differentiations are presented in the table:

Measles	A non-itchy maculopapular rash that tends to merge and appears in stages: on the first day – in the area of the face, neck, upper chest 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 – spreading to the lower limbs. The fusion of rashes in the area of the face leads to its puffiness, thickening of the eyelids, coarsening of the facial features, and a pronounced change in appearance.
Scarlet fever	A small, non-itching, pinpoint rash appears on the first or second day of the disease, localized on the reddened areas of the neck, upper chest, and back. Within 24 hours, it spreads to the entire body. A cluster of rashes is noted in the area of skin folds (neck, armpits, groin, popliteal fossa, etc.).
Rubella	A rash without itching appears within 24-48 hours from the onset of the disease. It quickly spreads to the face, chest, abdomen, back, arms and legs. The rash is finely spotted, the elements have even configurations, pale pinkish, abundant. The spots do not rise above the skin surface, and turn pale when pressed. A cluster of spots is observed in the area of extension of the limbs, as well as on the back and buttocks. The background of the rash is normal skin. A 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, suddenly, more often - like scarlet fever (small dot). The color range is from pale pink to bright purple-blue. The skin background also varies. The localization is symmetrical. In some cases, itching may be present. The rash disappears within 24 to 144 hours.
Enterovirus infection	A rash without itching appears suddenly, against the background of unchanged skin. The main elements are spots, papules, small dots, hemorrhages. They disappear without a trace within 24-48 hours.
Meningococcemia	A rash without itching appears in the first 24 hours of the disease. It is diverse and of different sizes: the elements are represented by spots, papules, hemorrhages, "stars" of irregular configuration with a compaction in the center. The nature of the rash is gradual, with increasing dynamics. Dominant location: buttocks, legs. Skin background - unchanged. As the intense rash disappears in some places, areas of necrosis are formed.
Typhoid fever	Roseolas are present as 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, and tend to periodically appear. They disappear without a trace after 24-120 hours.
Herpes infection	A local rash is observed on a limited area of the skin, on which pain, burning, redness appear beforehand, and only then – vesicles with serous contents. The skin is edematous, reddened. After opening, weeping erosions are found, covered with crusts with subsequent epithelialization. Preferential localization: labial border, nose, cheeks or forehead, buttocks and thighs, forearms, hands.

Treatment itchless rash

Treatment for patients with a rash without itching varies, as it depends on the origin of this symptom and the reason for its appearance.

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

In the case of an allergic process, for example, treatment begins with stopping the action of the allergen, after which the drug-based elimination of the pathological signs is carried out using antihistamines and other drugs. It is recommended to take such drugs as Loratadine, Desloratadine, Diazolin, Suprastin. In complex 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 medications as part of complex therapy. These may be antibiotics, sorbent and detoxifying drugs, antiviral agents, immunoglobulins, etc. In particular, patients with bacterial dermatitis of staphylococcal or streptococcal nature are definitely prescribed antibiotics with a wide spectrum of antimicrobial activity. Macrolide drugs (Azithromycin) are recommended, and Ceftriaxone is often prescribed. Most patients with pyoderma note improvement after regular treatment of areas with rash without itching with solutions of fucorcin or brilliant green.

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

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

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

Medicines

For most patients with bacterially caused rash without itching, medications are selected empirically. Most often, it is sufficient to take Dicloxacillin at a dosage of 250 mg orally, or Cephalexin at a dosage of 500 g 4 times a day. Levofloxacin at 500 mg once a day or Moxifloxacin at 400 mg once a day orally are no less effective. If the patient is allergic to penicillins, then it is possible to prescribe Clindamycin at 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 non-itchy rash caused by fungal infection involves the use of antifungal agents, which are prescribed in the form of tablets, ointments and creams, solutions for local application. The duration of the treatment course is determined by the doctor.

In general, your doctor may prescribe the following medications, depending on the cause of your non-itchy rash:

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 that are sensitive to the action of corticosteroids. It is not recommended for use by women during pregnancy. Apply to the skin carefully, rubbing in slightly, twice a day. Possible side effects: 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 origin with secondary infection. It is applied to the skin twice a day, without a bandage. The optimal duration of use is no more than 2 weeks (on the skin of the face - no more than one week). It is used for children from 2 years of age, no more than once a day, excluding the face area.
Elokom	A synthetic glucocorticoid drug mometasone. It is prescribed for dermatoses and atopic dermatitis in adults and children over 2 years of age. The ointment or cream is usually applied once a day. Contraindications: acne vulgaris, pyoderma, diaper dermatitis, parasitic and fungal infections, tuberculosis, syphilis, post-vaccination reactions.
Restorative, healing preparations
Bepanten	Used to eliminate rashes without itching in patients of any age, including children. Indications include: rashes caused by radiotherapy, phototherapy, ultraviolet radiation, and diaper dermatitis. The ointment can be used one or more times a day under the supervision of a doctor. Possible side effects: allergy.
Losterin	A complex cream designed to treat various forms of dermatoses and dermatitis accompanied by dry skin and rash. The cream is approved for use from the age of 3 months, applied in a thin layer to 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 rash
Persen	A herbal sedative, prescribed to adults 2-3 tablets three times a day, regardless of food intake. Side effects: general weakness, dizziness, hypersensitivity reactions.
Novo-Passit	It is successfully used for psychosomatic dermatoses in adult patients and children over 12 years old. Usually take 1 tablet three times a day. The recommended course of treatment is one month. Possible side effects include: drowsiness, allergies, muscle weakness, difficulty breathing.
Antiallergic agents
Loratadine	Tricyclic antihistamine, prescribed for allergic-caused rash without itching. Can be taken from 2 years of age (the dose depends on the child's weight). Possible side effects: drowsiness, headache, change in appetite, fatigue.
Desloratadine	A 2nd generation antihistamine used for allergic rashes 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 the age of six months according to individually calculated dosages. Side effects 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	Eliminates rashes caused by fungal pathogens such as dermatophytes, mold, yeast and dimorphic fungi. The cream is used locally 2 times a day. Possible side effects: allergy.
Antiviral drugs
Acyclovir	Antiviral ointment, active against herpes simplex virus types 1 and 2. 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 action 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 the herpes simplex virus. Use about 5 times a day, for at least 4 days. Children are allowed to use the drug from the age of 12.

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

Physiotherapy treatment

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

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

• electrosleep (use of pulsed currents by applying electrodes to the head area);
• central electrical stimulation TES (relieves pain, 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, prednisolone or hydrocortisone ultraphonophoresis 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 gland zone, or indirectly transcranially. Under the influence of the 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 the suppression of allergic processes.

Local procedures help to slow down the inflammatory reaction, improve blood circulation, remove inflammation mediators, and reduce the excitation of skin receptors. The following types of physiotherapy are relevant in this aspect:

• TNC therapy (ultraton therapy) and darsonvalization;
• electrophoresis with antiallergic agents, galvanization;
• local magnetic therapy;
• UV irradiation of the inflamed area;
• laser therapy.

The choice of treatment method depends on individual indicators. Most patients are prescribed a combination of several physiotherapeutic procedures of both general and local impact.

Contraindications to physiotherapy are:

• any new formations in the area of application;
• decompensated conditions;
• general severe condition of the patient;
• fever period;
• acute form of tuberculosis;
• psychopathologies;
• bullous dermatoses;
• cutaneous porphyria;
• systemic lupus erythematosus;
• hypersensitivity to electric current;
• pregnancy period.

Ultraviolet irradiation is not prescribed to patients with summer psoriasis.

Herbal treatment

Traditional methods of therapy can also help with the appearance of a rash without itching. However, their use should always be agreed with a doctor, since illiterate self-medication can aggravate the problem, lead to the spread of the rash, which will subsequently require more complex and long-term treatment.

• A single rash on the back without itching is well eliminated by using herbal infusions prepared from plants with an anti-inflammatory and drying effect. Calendula and chamomile are considered especially popular in this situation, which is due to their availability and effectiveness. To prepare a medicinal infusion, take 1 tbsp. of crushed flowers, pour 200 ml of boiling water and insist under the lid until cool. Then strain the liquid and use for rinsing and lotions three times a day.
• If the rash without itching is caused by infectious processes, then experts advise taking infusions of medicinal herbs internally. Among the recommended plants is oregano, which is steamed with boiling water in an enamel mug and infused for half an hour. The warm infusion is taken 20 minutes before meals, 1 tbsp. 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.
• The juice of celandine or aloe has a drying effect. To obtain a healing agent, one of these plants is crushed, the resulting gruel is squeezed until juice is obtained, which is then 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 infusions, herbal teas, tinctures, etc. However, it is necessary to take into account that self-medication can cause significant harm, so any type of treatment should be agreed with a doctor.

Surgical treatment

Surgical tactics can be applied to the following pathologies:

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

The specific treatment options for a specific patient are determined during an examination by a surgeon. To clarify the diagnosis, ultrasound diagnostics, X-rays, dermatoscopy, tissue biopsy, and laboratory tests may be prescribed.

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

In dermatology, the Surgitron radiosurgical device is often used, which has a number of advantages: it causes minimal tissue damage, 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:

• under no circumstances should you scratch or squeeze out the rash elements, or try to act on them in any other way (mechanically, chemically, etc.);
• do not self-medicate;
• do not open blisters or pustules;
• Do not use aggressive external agents, do not apply coloring solutions (brilliant green, fucorcin) to the area of the rash, so as not to distort the picture that the doctor will subsequently see.

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 underlying cause, rashes can be one of the manifestations of dangerous and even serious diseases.

• Complications of measles can include pneumonia, otitis, and sometimes encephalitis.
• Complications of mumps include inflammation in glandular organs and the development of viral meningitis.
• Urticaria can be complicated by Quincke's edema, a serious condition accompanied by bronchospasms, shortness of breath and other rapidly increasing symptoms that, if left untreated, can lead to death.
• Complications of meningococcemia are infectious toxic shock and multiple organ failure. In severe cases, there is always 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 severity may be associated with the primary disease.

Prevention

Prevention of the appearance of a rash without itching consists of eliminating the possible causes of this phenomenon.

If a person is prone to allergies, then he should:

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

You can prevent a non-itchy rash of infectious origin if:

• regularly observe all sanitary and hygienic rules;
• avoid contact with sick people;
• avoid staying in areas with large crowds of people, which is especially important during periods of exacerbation of infectious diseases (epidemics);
• get vaccinated on time;
• avoid using other people’s hygiene products, clothing, etc.;
• regularly carry out wet cleaning and ventilate the premises;
• eat well, make sure your diet contains the necessary vitamins and minerals, as well as the balance of proteins, fats and carbohydrates.

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

Forecast

Determining the cause and further treatment of a rash without itching always takes 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 skin area regress relatively quickly against the background of timely antibacterial therapy. In the absence of treatment, necrotizing subcutaneous processes, bacteremia with the spread of infectious foci may develop. Exacerbations often occur.

Without timely treatment, the rash without itching may worsen and become widespread.