Healthy Living

Maculopapular Rash: Symptoms, Causes, and Treatment

Maculopapular Rash: Symptoms, Causes and Treatment

Introduction to Maculopapular Rash

A maculopapular rash is a lesion that can appear as flat or raised skin. The name “maculopapular” itself is a blend of two words: “macule” meaning flat, discolored skin lesions, and “papule”, which means a small, raised bump. The skin lesions can merge together and are usually red in color.

Macules are bigger than one centimeter and are usually seen as patches on the skin. Papules, which appear merged together, can be considered as plaques. Papules measure less than one centimeter and are an elevated lesion. The other names for maculopapular rash are exanthematous eruption, exanthema, and morbilliform.

A maculopapular rash is an indication of various illnesses, infections, or allergic reactions. Many times, the actual cause of a maculopapular rash is a viral infection. Visit your doctor if you have a maculopapular rash, as it can be a sign of a serious medical condition.

The distribution of a maculopapular rash can either be concentrated at a certain area of the body, or it can be generalized. Maculopapular rashes can be acute, chronic, or subacute. An acute maculopapular rash lasts for less than four weeks, subacute rashes last for 4-8 weeks, and chronic maculopapular can last for more than eight weeks.

A viral infection is one of the most common causes of a maculopapular rash in children. In adults, the most common causes are certain drugs and allergic reactions. There are many factors associated with a maculopapular rash, which may not be dangerous.

When an individual has a maculopapular rash without fever, it is not necessarily a major problem. But if the person is weak and has a high fever as well as other symptoms along with the rash, it could be a sign of a serious illness and should not be ignored.

Characteristics and Identification of a Maculopapular Rash

There are many possible causes of a maculopapular rash, but one of the most indicative factors is the pattern of papules and macules. The maculopapular rash can look like a patch of red skin or a red bump on a flat surface.

However, if a person’s skin is dark, the red background of the rash would not be very visible. The maculopapular rash can cause itching at times and usually lasts for 2-3 days, but can go up to three weeks before it completely heals. The healing period is dependent on the exact cause of the rash.

The cause of the rash depends on how quickly and on which part of the body it appeared. The rash can spread to any part of the body, from the face down to the limbs.

Maculopapular rashes are very common in people who have infections or an impaired immune system. Such people will also experience other symptoms, including:

  • Irregular breathing
  • Sudden high temperature
  • Dry skin
  • Muscle pain 
  • Headache
  • Nausea
  • Vomiting

In such cases, one should quickly check with the doctor, since it could be a potential sign of a contagious infection. The doctor will conduct certain examinations to discover the root cause.

What are the causes of a maculopapular rash?

Maculopapular rashes appear in people with various conditions. They can be due to:

  • Allergies: Allergies can cause rashes to break out immediately, within a few minutes or hours if the person is being exposed to the allergen. In some cases, before hives appear, a maculopapular rash will break out. Apart from the rash, the person suffering from allergies would also experience other symptoms, such as an increased or irregular heart rate followed by a breathing difficulty.
  • Reaction to drugs: If one is on medication, a side effect or allergic reaction to it can cause a maculopapular rash. However, in such cases, the rash would appear 4 to 12 days after consuming the medication. Any medication reactions usually take up to seven or eight days for the symptoms to show up. Apart from the rash, one may also experience muscle pain and a sudden fever. Rashes due to drug reactions usually go away within one to two weeks. Chemotherapeutic medications can also result in a maculopapular rash.
  • Maculopapular rash in children: The main cause of maculopapular rash in children is viral infections such as roseola, Epstein-Barr virus, adenovirus, or rubella virus.
  • Viral or bacterial infections: If a person is suffering from a viral or bacterial infection, he or she would experience symptoms of a maculopapular rash. Apart from this rash, there would also be other symptoms, such as trouble breathing, pain in the muscles, increased heart rate, or fever. Some of the viral infections that can induce a maculopapular rash are:
  • Dengue fever: One of the primary causes of a maculopapular rash is dengue fever. It is spread through mosquitoes and is characterized by fever, pain in the joints, and rashes. This condition becomes very lethal if the person’s platelet count drops, leading to excessive bleeding and eventually death.
  • Scabies: Scabies is a contagious condition that can cause itching, leading to irritation of the skin.
  • Low cholesterol: Individuals who have low cholesterol are most likely to develop a maculopapular rash. The condition happens due to an excessive use of vitamin B3 or niacin in the body.
  • Body inflammation: A maculopapular rash can also be due to the body’s systemic inflammation. Inflammation is how the body responds to any type of infection or injury. Reaction to medications or drugs, or an allergic reaction can all cause the body’s immune system to respond in the form of a maculopapular rash.

Pointers to Keep in Mind When Visiting the Doctor

If an individual has a maculopapular rash, the first thing to do is to consult the doctor. Since there are many possible causes of the rash, an exact diagnosis may be a bit difficult.

The doctor will first ask about your medical history and if you have recently traveled. The doctor will also conduct a physical examination and asks where the rash first appeared. Additional questions will be asked to determine the rash’s root cause, including:

  • When did the rash first appear?
  • Are there any other symptoms apart from the rash such as fever, diarrhea, conjunctivitis, sore throat, or fatigue?
  • Do you have any other medical condition such as diabetes, high blood pressure, or a heart condition?
  • Are you consuming any other medications or over-the-counter drugs?
  • Are you allergic to any drugs, medications, insects, or food?
  • Have you been in contact with people or animals with a contagious disease?
  • Have you recently traveled to places with mosquito-borne diseases such as chikungunya or Zika?

The doctor will request a blood or urine test depending on the individual’s medical history and the course of the rash. The doctor can also conduct a skin biopsy and then refer a skin specialist for further treatment.

The doctor may request a complete blood count (CBC), syphilis test, cerebrospinal fluid (CSF) test, or culture test of the rashes. These tests are to be carried out under the guidance of a trained medical professional.

If required, the doctor will also ask for an ENT test or lung, nerve, or joint tests. A maculopapular rash can also be diagnosed based on the symptoms one is experiencing. If the rash appears on the face, it could be due to measles or another viral infection. If the rash is accompanied by a headache or feelings of confusion, the cause would be gonococcemia.

How to Treat a Maculopapular Rash

The exact cause of a maculopapular rash decides the course of treatment. If the person is experiencing itching issues, the doctor can prescribe antihistamines or a topical steroid to relieve the itching.

There are certain over-the-counter medications, such as Benadryl or hydrocortisone creams, which also provide relief. However, it is of utmost importance to first visit the doctor before taking these medications because it can complicate matters if they are taken without knowing the exact cause of the symptoms. Below are the treatments based on the cause of the problem:

  • Viral or bacterial infections: If the doctor identifies viral or bacterial infections to be the root cause of the maculopapular rash, medications would be given to treat that particular disease. An example would be the Zika virus causing a maculopapular rash. Currently, there is no known treatment for Zika. In such cases, the doctor would advise complete rest, drinking of plenty of fluids, and over-the-counter painkillers to get pain relief.
  • Reaction to certain drugs: If the individual has a maculopapular rash due to the intake of certain medications, the doctor would ask you to stop the medication or would prescribe an alternative. In some cases, the doctor would check if a reduced dosage could solve the problem.
  • Systemic inflammation: In this instance, the doctor would first try to determine the cause of the inflammation or what is causing the immune system to react in a particular way.
  • Allergies: The doctor can prescribe certain antihistamines for those suffering from allergic reactions. For inflamed skin, the doctor can prescribe wet wraps or steroid creams to relieve the pain. A person suffering from chikungunya may develop a maculopapular rash. The condition is diagnosed with the help of a serologic test. Treatment for this disease is chloroquine, which is an anti-inflammatory medication that helps alleviate the medical condition and its symptoms.
  • Oral rehydration: Those suffering from dengue can be given intravenous fluids or oral rehydration. However, those with a severe condition would need blood transfusions.
  • Painkillers: If the cause of the maculopapular rash is the Epstein-Barr virus, the doctor would prescribe certain painkillers and other types of analgesics for the patient.

Risks and Complications 

An individual with a maculopapular rash would feel uneasiness, pain, and itching, without much complications. However, there can be certain risks based on the underlying cause of the rash.

Intake of certain medications can cause life-threatening allergic reactions known as anaphylaxis. One may experience symptoms such as fever, headache, stiffness in the neck, or back pain due to viral or bacterial infections. However, the doctor can clearly identify the cause based on the symptoms you are experiencing.

A maculopapular rash is often seen along with the new and deadly virus called the Zika virus. Zika is especially dangerous when it affects pregnant women, as the virus is deadly for newborns by hampering their brain and body development.

Zika is also known to cause another disorder associated with the brain, called the Guillain-Barre syndrome. Hence, if a pregnant woman notices a maculopapular rash, it is very important that she visits the doctor since it is possible that she has contracted the Zika virus.

Zika virus is transmitted to people through mosquito bites or by having unprotected sex with a Zika-infected partner. Thus, doctors advise pregnant women to either abstain from sex or have protected sex in such situations.