Home » Skin Conditions » Atlas of Rashes Associated With Fever (Pictures)

Atlas of Rashes Associated With Fever (Pictures)


This atlas is an attempt to depict the most common and important rashes that we see in our daily life. It necessarily is not in order of importance.

Neither is it possible to describe all the rashes which we see. Nevertheless, we have given an honest effort to collate the most important ones here.

Atlas of Rashes Associated with Fever

Streptococcal Toxic Shock Syndrome

Toxic shock syndrome, as the name indicates, is toxin mediated. Organisms such as Group A Streptococcus (Streptococcus pyogenes) and Staphylococcus aureus can cause this condition. Streptococcus pyogenes produce a toxin Streptococcal pyrogenic exotoxin.

The toxin when passed into the circulation results in hypotension, high fever, multi organ failure (3 or more organ systems are involved), vomiting, diarrhoea, headache and rashes. There can also be skin peeling out of palms and soles [1].

Streptococcal Toxic Shock Syndrome Rash Pictures

Image 1 : https://syndromespedia.com/wp-content/uploads/2014/06/toxic-shock-syndrome.jpg
Toxic shock syndrome rash on leg.

Image 2: https://syndromespedia.com/wp-content/uploads/2014/06/Toxic-Shock-Syndrome-Picture.jpg
Toxic shock syndrome rash on the trunk of a patient.

Image 3: http://2.bp.blogspot.com/-85JoZnPtkxg/VUy3u3Tr3YI/AAAAAAAAC_8/jOm4ekRI42k/s400/Toxic%2BShock%2BSyndrome%2B-%2Btss.jpg
Desquamation in palm due to toxic shock syndrome.

Scarlet fever (Second Disease/ Scarlatina)

The disease is caused by Streptococcus pyogenes. The toxins produced by this bacterium can cause Scarlet fever. It usually follows a throat infection by the same bacteria. Sore throat with swollen glands, high fever, rashes, flushed face, pallor around the mouth and strawberry like tongue could be scarlet fever.

A doctor has to confirm the diagnosis after appropriate examination and investigations. The rashes generally start from the face or neck and then spread down to the limbs and trunk[2].

Scarlet fever (Second Disease/ Scarlatina) Rash Pictures

Image 4: http://kidspot.co.nz/wp-content/uploads/2017/05/scarlet-fever.png
Rashes of scarlet fever over neck and trunk.

Image 5: http://tonguepictures.org/large/47/Strawberry-Tongue-Pictures-2.jpg
‘Strawberry tongue’ in a child with Scarlet fever

Image 6: https://www.drugs.com/mcd/images/image_popup/DS00917_IM00998_r7_scarletfeverthu_jpg.png
Scarlet fever rashes on upper limbs and back

Image 7: https://ichef-1.bbci.co.uk/news/660/media/images/81626000/jpg/_81626007_scarlet_fever_on_the_face-spl.jpg
Scarlet fever rash on a child’s face.

Staphylococcal Toxic Shock Syndrome

Here, the organism causing toxic shock syndrome is Staphylococcus aureus. The toxin produced by staphylococcus which causes this condition is Toxic Shock Syndrome Toxin-1 (TSST-1). The toxin when passed into the circulation results in hypotension, high fever, multi organ failure (3 or more organ systems are involved), vomiting, diarrhoea, headache and rashes.

There can also be skin peeling out of palms and soles[1].

Staphylococcal Toxic Shock Syndrome Rash Pictures

Image 8: http://www.nejm.org/na101/home/literatum/publisher/mms/journals/content/nejm/2013/nejm_2013.369.issue-9/nejmicm1213758/20130823/images/medium/nejmicm1213758_f1.gif
Desquamation (skin peeling off) of palm can be seen in a case of Staphylococcal toxic shock syndrome.

Image 9: http://i0.wp.com/www.ladycarehealth.com/wp-content/uploads/2012/05/tss.jpg?w=300
Toxic shock syndrome rashes on abdomen.

Image 10: http://www.primehealthchannel.com/wp-content/uploads/2013/06/Toxic-Shock-Syndrome-Picture-300×197.jpg
Desquamation (skin peeling off) of palm can be seen in a case of Staphylococcal toxic shock syndrome.

Image 11: http://4.bp.blogspot.com/_c_a8Mekl9hE/TRLs-y2Tb2I/AAAAAAAABB4/8zH2sOEj3C8/s1600/toxic-shock-syndrome-3.jpg
Rashes in Toxic shock syndrome.

Staphylococcal Scalded Skin Syndrome

The disease is caused due to a toxin, Epidermolytic toxin produced by Staphylococcus aureus. The toxin spreads through the blood and can cause lesions that resemble scalding (burns caused by hot water or liquids). Mostly it is seen in children below 5 years of age though it can affect any aged person. In new born, the condition is also called as Ritter’s disease.

The child may present with fever, irritability, redness of the skin and fluid filled blisters. Peeling off of large areas of skin may occur [3].

Staphylococcal Scalded Skin Syndrome Rash Pictures

Image 12: https://www.researchgate.net/publication/279251213/figure/fig1/AS:325026801831949@1454503836748/Staphylococcal-Scalded-Skin-Syndrome-in-a-newborn-with-generalized-bullous-epidermolysis.png
Staphylococcal scalded skin syndrome

Image 13: http://www.nejm.org/na101/home/literatum/publisher/mms/journals/content/nejm/2000/nejm_2000.342.issue-16/nejm200004203421605/production/images/medium/nejm200004203421605_f1.gif
Staphylococcal scalded skin syndrome

Image 14: https://www.alpfmedical.info/causative-agent/images/4582_792_769-blister-wrist-producing-clear-liquid.jpg
Staphylococcal scalded skin syndrome

Image 15: http://cmr.asm.org/content/12/2/224/F2.medium.gif
Staphylococcal scalded skin syndrome

Pseudomonas “Hot-Tub” Folliculitis

‘Follicle’ is the lower part of a hair strand. When an infection occurs in the follicle, it is called as folliculitis. In people frequently using a hot tub or swimming pool, Pseudomonas aeruginosa can get to the base of hair and cause folliculitis.

It can be seen as vesicles or pustules at the follicles of areas which come in contact with water for a longer time. Generally it involves abdomen, buttocks, axillae etc[4].

Pseudomonas “Hot-Tub” Folliculitis Rash Pictures

Photo 16: http://www.clean-pool-and-spa.com/images/pseudomonas_folliculitis_25.jpg
Hot Tub Folliculitis

Photo 17: http://www.clean-pool-and-spa.com/images/pseudomonas_folliculitis_24.jpg
Hot Tub folliculitis

Photo 18: http://www.wrinkle-free-skin-tips.com/images/pseudomonas-dermatitis-contact-dermatitis-illustrations.jpg
Hot Tub Folliculitis. Note the vesicle at the root of hair follicles

Photo 19: http://www.huidziekten.nl/afbeeldingen/gram-negatieve-folliculitis-1.jpg
Hot tub folliculitis

Ecthyma gangrenosum

Ecthyma Gangrenosum, most commonly caused by Pseudomonas aeruginosa, is usually seen in patients with low immunity. When the immunity is low any infection can easily occur. The organism enters through a break in skin or through infection in any other parts of the body.

The lesion seen is initially a macule (<1 cm wide skin discoloration) which rapidly aggravates into a haemorrhagic pustule. The area degenerates (gangrene formation) with surrounding erythema (redness) and central scar (eschar) formation[5].

Ecthyma gangrenosum Rash Pictures

Photo 20: http://www.atlasdermatologico.com.br/img;jsessionid=26DE1D34AF43628537E7F72901CBFD40?imageId=1572
Ecthyma gangrenosum. Eschar can be seen in the picture.

Photo 21: http://www.atlasdermatologico.com.br/img;jsessionid=26DE1D34AF43628537E7F72901CBFD40?imageId=1573&thumb=1
Ecthyma gangrenosum. Eschar can be seen in the picture.

Photo 22: https://mddk.com/wp-content/uploads/2015/02/ecthyma-gangrenosum-pictures-2.jpg
Ecthyma gangrenosum.

Photo 23: https://mddk.com/wp-content/uploads/2015/02/ecthyma-gangrenosum-pictures.jpg
Ecthyma gangrenosum.

Thrombotic thrombocytopenic purpura (TTP)

The three parts of the name make it easy to understand the condition. Due to thrombosis (blockage of small blood vessels), there is a decrease in platelet count. When platelet count decreases, there can be minute bleeding into the layers of skin called as petechiae.

Along with petechiae, there can be central nervous system involvement (seizures, paraesthesia, visual disturbances etc) and anaemia (fatigue)[6, 7].

Thrombotic thrombocytopenic purpura (TTP) Rash Pictures

Image 24: https://www.researchgate.net/profile/Sujata_Chandra/publication/255953232/figure/fig1/AS:214157531062273@1428070542916/Purpuric-rash-on-forearm-and-multiple-vascular-access-lines-in-a-patient-with-thrombotic.png
Thrombotic thrombocytopenic purpura in a pregnant lady.

Image 25: https://www.nhlbi.nih.gov/sites/www.nhlbi.nih.gov/files/images_273
Thrombotic thrombocytopenic purpura.

Image 26: http://www.thromboticthrombocytopenicpurpura.com/TTP.jpg
Thrombotic thrombocytopenic purpura.


Tularemia is a zoonotic (disease spreading from animals to man) affecting rodents and hares caused by an organism Francisella tularensis. It enters human body through tick bite, ingestion of contaminated water, eyes, or by skin contact with infected animals. It is highly contagious and can be life threatening if not treated promptly.

Tularemia is characterized by lesions that are characteristic based on their route of entry. When the route of entry is skin, there can be ulceration with lymph node enlargement. Whereas, if the route of entry is eyes, then there can be irritation and inflammation of the eye. If it enters the body by ingestion of contaminated water or food, then it may cause tonsillitis, ulcerations in mouth and enlargement of the glands in neck[8, 9].

Tularemia Rash Pictures

Image 27: https://www.researchgate.net/profile/Binnur_Onal/publication/237818997/figure/fig3/AS:281697489834002@1444173323726/Figure-1-Cervical-lymphadenopathy-in-oropharyngeal-type-tularemia-infection.png
A case of Tularemia (oropharyngeal type) with cervical lymphadenopathy (enlarged lymph nodes)

Image 28: https://img.medscapestatic.com/pi/meds/ckb/35/37535tn.jpg
Tularemia under the nail due to rabbit bite.


Anthrax is another zoonotic disease which is caused by an organism, Bacillus anthracis. According to the route of entry, the features of disease can be seen. On the skin, it is seen as a papule which develops into an eschar[10].

Anthrax Rash Pictures

Photo 29: http://media.infectiousdiseaseadvisor.com/images/dsm/ch2175.fig1.jpg
Cutaneous type of anthrax with eschar on the cheek of a person.

Photo 30: http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/infectious-disease/biologic-weapons-and-primary-care/images/Biologicfig1_thumb.jpg
Photo shows eschar formation in anthrax with surrounding erythema (redness)

Photo  31: http://diseaseslab.com/wp-content/uploads/2015/07/Anthrax-3.jpg
Lesion in cutaneous anthrax

Photo 32: http://tip10.info/wp-content/uploads/2017/02/ab9fd8e957bb805ebe07f178ba4068c4.jpg
Anthrax lesion

Lyme disease

It is transmitted by ticks to humans and most commonly caused by Borrelia burgdorferi. At the site of bite, an area of redness develops and expands (Erythema migrans). Other features include joint pains, headache, palpitations, facial paralysis etc. Occasionally it may show a ‘Bull’s eye’ appearance[11].

Lyme disease Rash Pictures

Image 33: http://www.dogarmor.net/wp-content/uploads/2013/04/erythema-migrans-436-x-300.jpg
‘Bull’s Eye’ Appearance in Lyme’s disease.

Image 34: http://cursoenarm.net/UPTODATE/contents/images/f13/62/14310.myextj?title=Erythema+migrans+-+close+view
Erythema migrans seen in Lyme’s disease

Image 35: http://www.spokesman-recorder.com/wp-content/uploads/2014/07/advice.erythema-migransweb.49.jpg
Erythema migrans rashes

Image 36: http://media.syracuse.com/news/photo/2012/06/11228089-large.jpg
A lesion showing ‘Bull’s eye’ appearance of rash in case of Lyme’s disease.

Relapsing fever

Relapsing fever is also caused by Borrelia species. Borrelia recurrentis is transmitted by louse and causes epidemic relapsing fever/louse borne relapsing fever. Whereas Borrelia hermsii and few other borrelia species is transmitted by ticks and causes endemic relapsing fever/tick borne relapsing fever.

High fever which occurs recurrently along with period of crisis due to severe hypotension marks this disease. This disease can be fatal if not treated appropriately [12, 13, 14, 15].

Relapsing fever Rash Pictures

Image 37: https://www.licesquad.com/wp-content//uploads/2014/04/imagesI67TN4TC.jpg
Rash seen in relapsing fever.

Secondary syphilis

Syphilis, a sexually transmitted disease has 4 stages, primary, secondary, latent and tertiary. The secondary stage presents with rashes all over the body but mostly on palms and soles. It can also show generalized lymphadenopathy (enlarged lymph nodes) and condyloma lata (wart like lesion in the genitalia and perineum)[16, 17, 18].

Secondary syphilis Rash Pictures

Image 38: https://privatetestingcenter.com/wp-content/uploads/2015/05/Syphilis-Figure-5-full.jpg
Image shows rashes seen in secondary syphilis, in palms.

Image 39: http://cmr.asm.org/content/18/1/205/F1.large.jpg
Secondary syphilis with rash over trunk.

Image 40: http://www.cmaj.ca/content/176/1/33/F1.large.jpg
Secondary syphilis- generalized rashes

Image 41: https://www.researchgate.net/profile/Milan_Bjekic2/publication/287360570/figure/fig2/AS:360965741793283@1463072347678/Figure-3-Characteristics-papulosquamous-lesions-of-secondary-syphilis-on-the-soles.png
Secondary syphilis- Rashes on soles.

Typhoid fever

Typhoid fever is caused by Salmonella typhi and paratyphi groups which spreads generally through contaminated food or water. It presents as high fever with diarrhoea, joint pains, headache, tiredness, and anorexia. It may also show rashes called as ‘Rose spots’[19, 20].

Typhoid fever Rash Pictures

Image 42: https://quatr.us/wp-content/uploads/2017/09/typhoidrash-251×300.jpg
Rash in typhoid fever.

Image 43: https://onlinejindagi.files.wordpress.com/2015/05/taiphod.jpg
Typhoid fever- Rose spots

Image 44: https://image.slidesharecdn.com/feverwithrash-141128102422-conversion-gate01/95/fever-with-rash-50-638.jpg
Typhoid fever- Rose spots.

Rickettsial Pox

It is caused by an organism Rickettsia akari and transmitted by mites. A papule which develops into vesicles followed by ulceration and eschar formation occurs. Systemic symptoms like high fever, headache, throat pain, muscle aches, chills & rigor, vertigo, nausea etc can be seen. It usually resolves by itself [21, 22, 23].

Rickettsial Pox Rash Pictures

Image 45: https://images.emedicinehealth.com/images/image_collection/skin/rickettsialpox-tache-noire.jpg
Rickettsial pox- eschar formation.

Image 46: http://www.rugusavay.com/wp-content/uploads/2013/08/rickettsialpox.jpg
Rickettsial pox- eschar formation.

Image 47: http://dxline.info/img/new_ail/rickettsial-pox_2.jpg
Rickettsial pox- The vesicles may resemble those in chicken pox.

Rocky Mountain spotted fever

RMSF is caused by Rickettsia rickettsii. The disease usually presents with high fever, headache, muscle pain, nausea and rashes. The non-itchy petechial rashes appears on ankles and wrists which spread over to the palms, soles and other parts of the body[24, 25].

Rocky Mountain spotted fever Rash Pictures

Photo 48: https://www.healthline.com/hlcmsresource/images/Image-Galleries/rocky-mountain-spotted-fever/642x361_Rocky_Mountain_Spotted_Fever_SLIDE_1.jpg
Rashes of Rocky Mountain Spotted fever on a child’s forearm and hand.

Photo 49: http://media.dermatologyadvisor.com/images/dsm/ch1396.fig1.jpg
Petechial rashes of Rocky Mountain spotted fever on leg.

Photo 50: https://img.webmd.com/dtmcms/live/webmd/consumer_assets/site_images/articles/image_article_collections/mcgraw_hill_skin_atlases/childhood_skin_problems/CAPD_rocky_mountain_spotted_fever.jpg?resize=646px:*&output-quality=100
Rocky Mountain Spotted fever- Rashes on ankles, legs and soles.

Typhus Fever

Epidemic typhus is a rickettsial disease caused by Rickettsia prowazekii. The organism enters the human body through louse. The symptom of the disease includes, fever, muscle pains, nausea, vomiting, lethargy and rashes. In some people, the organism may persist even after the symptoms disappear. These organisms get reactivated when the immunity decreases and can cause the recurrence called as Brill-Zinsser disease.

Endemic typhus, also known as Murine typhus, is another rickettsial disease caused by Rickettsia typhi. The organism is usually transmitted by rat flea. The symptom of the disease includes, fever, muscle pains, nausea, vomiting, lethargy and rashes[26, 27, 28, 29].

Typhus Fever Rash Pictures

Image 51: https://image.slidesharecdn.com/feverwithrash-141128102422-conversion-gate01/95/fever-with-rash-42-638.jpg?cb=1489760875
Epidemic Typhus fever rash

Image 52: http://www.natural-health-news.com/wp-content/uploads/2017/08/Typhus.jpg
Epidemic Typhus fever rash

Image 53: https://www.microbiologysociety.org/uploads/assets/derivatives/300x291_highestperformance_/bb7acf8c-ed53-4638-952e601cf17bb5c4.jpg
Epidemic Typhus fever rash

Image 54: http://westjem.com/wp-content/uploads/2013/01/103-207-f-273×300.jpg
Endemic typhus

Scrub typhus

Scrub typhus is caused by Orientia tsutsugamushi. The organism enters the body through bite of a mite. An eschar formation occurs at the site of the bite. Systemic involvement including cardiac, pulmonary and central nervous system can occur. Generally a high fever, with eschar formation and constitutional symptoms such as lethargy, anorexia, nausea, headache etc occurs in an infection of scrub typhus [30].

Scrub typhus Rash Pictures

Photo 57: http://www.defence.gov.au/health/infocentre/journals/adfhj_apr06/images/10-3.jpg
An eschar formed at the site of mite bite in case of Scrub typhus.

Photo 58: http://www.atmph.org/articles/2013/6/6/images/AnnTropMedPublicHealth_2013_6_6_614_140221_f6.jpg
Eschar on thigh due to scrub typhus infection.

Photo 59: http://what-when-how.com/wp-content/uploads/2012/05/tmpDB12_thumb2.jpg
Sometimes the eschar formation might be hidden even on the scalp.

Primary HIV infection

In individuals who are recently infected with HIV, non-specific macules and papules may be seen. This is due to skin reaction which occurs when the immunity is low. Other symptoms related to primary HIV infection may be present. Skin rashes in HIV can vary widely as it depends on the organism and cause of the condition[31, 32, 33].

Primary HIV infection Rash Pictures

Image 60: https://img.medscape.com/pi/features/slideshow-slide/derm-hiv/fig2.jpg
Rash due to Kaposi’s Sarcoma in an HIV infected patient.

Image 61: https://img.medscape.com/pi/features/slideshow-slide/derm-hiv/fig5.jpg
Herpes zoster infection in an HIV infected patient.

Image 62: https://img.medscape.com/pi/features/slideshow-slide/derm-hiv/fig7.jpg
Molluscum contagiosum in a patient with HIV

Image 63: https://img.medscape.com/pi/features/slideshow-slide/derm-hiv/fig14.jpg
Exacerbation of psoriasis in an HIV infected patient.

Infectious mononucleosis

Infectious mononucleosis, also known as kissing disease, is well known for it being contagious with close contacts especially in the young. The disease is caused by Ebstein-Barr virus (Human Herpes Virus 4 /HHV4). The presentation of patient is usually with fever, sore throat, fatigue and enlarged lymph nodes. It may also show diffuse macules or papules, urticaria, petechiae and peri-orbital oedema[33, 34, 35, 36].

Infectious mononucleosis Rash Pictures

Image 64: http://www.elsevier.es/ficheros/publicaciones/14138670/0000001900000005/v1_201510011125/S1413867015000963/v1_201510011125/en/main.assets/thumbnail/gr1.jpeg
Infectious mononucleosis rash

Image 65: http://www.rocketswag.com/medicine/images/Infectious-Mononucleosis-And-Rash.jpg
Rash in case of a patient with infectious mononucleosis

Image 66: https://5minuteconsult.com/data/GbosContainer/49/s_36900_c40_f11.jpeg
Thick white covering over enlarged tonsils, seen in case of a patient with infectious mononucleosis.

Rubeola (measles, first disease)

Measles is a highly contagious infection, caused by virus, and spreads rapidly through air (cough, sneeze, speaking etc). Around 90% of people, who come in contact with the infected person, usually get infected. The initial symptoms resemble an upper respiratory tract infection with runny nose, fever, sore throat and swelling of the lymph nodes in the neck. In 2-3 days, white spots appear in the mouth (Koplik’s spot), which are characteristic of Measles.

Rashes start to break out from the face and then spread on to neck, trunk, arm, legs and feet. Initially they are flat, sometimes may be raised from the surface, and as they spread to the other parts of the body they may become joined together[33, 37, 38, 39].

Rubeola (measles, first disease) Rash Pictures

Image 67: http://www.abc.net.au/news/image/5022924-3×2-940×627.jpg
Measles infection in a child.

Image 68: http://nrvs.info/wp-content/uploads/2014/08/measles-boy-rash-1024×688.jpg
A child showing severe measles infection

Image 69: https://tgp.com.ph/blog/wp-content/uploads/2015/03/measles.jpg
A closer look on the rashes due to Measles in a child.

Rubella (German measles, third disease)

Rubella is also a contagious disease usually spreading among the children and the youth. It can present with rashes, lymphadenopathy (enlarged lymph nodes), fever, arthritis etc. The rashes start from the face and then spread downward. Rubella when infecting a pregnant lady can be dangerous to the child, for it may be born with cataract, heart disease and deafness[40].

Rubella (German measles, third disease) Rash Pictures

Image 70: https://assets.nhs.uk/prod/images/S_0917_rubella-rash_M2100375.width-1220.jpg
Rubella rash

Image 71: https://images.medicinenet.com/images/image_collection/skin/rubella.jpg
Rubella rash

Image 72: https://www.healthline.com/hlcmsresource/images/Clinical-Large-Images/648x364_Rubella.jpg
A closer look on the rashes due to Rubella

Erythema infectiosum (fifth disease)

This disease is spread through the air from infected persons. Parvovirus B19 is the organism causing this condition. Erythema infectiosum starts with fever, sore throat, runny nose, headache, abdominal pain etc. A period of around 7-10 days of no symptoms follows the initial period. Then the rashes appear on face giving the classical feature of ‘slapped cheek appearance’. Lace like reticular maculopapular rashes appear after 1-4 days[41].

Erythema infectiosum (fifth disease)  Rash Pictures

Image 73: https://www.dermquest.com/imagelibrary/large/042087HB.JPG
Rash of Erythema infectiosum can be seen on the cheeks of this child.

Image 74: https://assets.babycenter.com/ims/2013/04/slapped-cheek_wide.jpg?width=505
‘Slapped Cheek’ appearance on a baby due to Parvo B19 infection (Erythema infectiosum)

Image 75: http://nursingfile.com/wp-content/uploads/2015/12/5th_disease_08.jpg
The rashes in Erythema infectiosum may show a lacey appearance.

Exanthem subitum (roseola infantum, sixth disease)

Exanthem subitum is caused by Human Herpes Virus 6 (HHV6). The condition is characterized by a high fever initially which subsides abruptly within 3-5 days, followed by appearance of maculopapular rash over trunk and neck. The child may present with febrile seizures. It is usually seen in infants[42, 43, 33].

Exanthem subitum (roseola infantum, sixth disease) Rash Pictures

Image 76: https://assets.nhs.uk/prod/images/M2500057-Roseola_Infantum-_viral_rash-SPL.width-1220.jpg
Roseola infantum rash.

Image 77: https://www.consultant360.com/sites/default/files/transfer/Screen_Shot_2013-04-30_at_2.14.52_PM.png
Roseola infantum

Image 78: http://www.newkidscenter.com/images/10401767/image001.jpg
A closer look on Roseola rash

Image 79: https://assets.babycenter.com/ims/2017/01/roseola-infantum-recut.jpg?width=600
Roseola rashes on back of a child.

West Nile fever

West Nile fever is most commonly transmitted by mosquito bite. The mosquito would have collected the West Nile virus from birds which are natural hosts of this virus. Most of the people who get infected do not show any symptoms. Rest of them may present with fever, headache, body ache, nausea, vomiting, and skin rashes mainly on trunk and extremities.

In some, it may cause neurological disease such as meningitis or encephalitis[44, 45, 46].

West Nile fever Rash Pictures

Image 80: https://openi.nlm.nih.gov/imgs/512/50/3939474/PMC3939474_viruses-06-00606-g001.png?keywords=west+nile+virus,infection,rash
West Nile fever rash presented as diffuse maculopapular rash.

Image 81: https://www.healthline.com/hlcmsresource/images/Clinical-Large-Images/648x364_West_Nile_Virus_Infection.jpg
A closer look on the rashes due to West Nile fever.

Dengue fever

Dengue fever is caused by dengue virus which is transmitted by mosquito Aedes aegypti. It is characterized by severe body ache, headache, retro-orbital pain, vomiting, tiredness and high fever. Rashes appear throughout the body giving it a flushed appearance. Certain areas on the skin may show ‘islands of white in a sea of red’.

In few people dengue fever may complicate into Dengue Haemorrhagic Fever (DHF) or Dengue Shock Syndrome (DSS) [47, 48].

Dengue fever Rash Pictures

Photo 82: http://www.healthmds.org/wp-content/uploads/2017/05/Dengue-fever-rash.png
Rashes seen in dengue maybe raised bumps or petechial hemorrhages.

Photo 83: http://www.healthmds.org/wp-content/uploads/2017/05/Dengue-fever-rash-remedies.png
Rashes seen in dengue maybe raised bumps or petechial hemorrhages.

Photo 84: http://www.healthmds.org/wp-content/uploads/2017/05/Dengue-fever-rash-raised-small-bumps-on-skin.png
Rashes seen in dengue maybe raised bumps or petechial hemorrhages.

Photo 85: https://images.emedicinehealth.com/images/emedicinehealth/dengue_fever.jpg
Rashes in dengue fever

Chikungunya fever

Chikungunya fever is transmitted by the same mosquito as in case of Dengue fever, the Aedes aegypti. The virus after entering the body, can cause, fever, headache, arthritis and rashes. The rashes here are flat red patches which may show raised spots too[49, 50, 51].

Chikungunya fever Rash Pictures

Image 86: http://dominicanewsonline.com/news/wp-content/uploads/2014/01/chikungunya.jpg
Rash seen in a case of Chikungunya infection

Image 87: https://usercontent1.hubstatic.com/12191918_f520.jpg
Rash in Chikungunya infection

Hand-foot-and-mouth- disease

As the name implies the symptoms are seen as rashes on hand, foot and mouth. But it doesn’t mean they are limited to these areas. The condition initiates with fever, sore throat, running nose etc. In 1-2 days, rashes appear on the palms, soles, thighs, buttocks, face, abdomen and mouth. This may continue onto becoming blisters.

The disease is transmitted by direct or indirect contact with infected persons. It is caused by Coxsackie virus and is usually seen below the age of 10 years, but may affect the adults too[52, 53].

Hand-foot-and-mouth- disease Rash Pictures

Image 88: https://upload.wikimedia.org/wikipedia/commons/5/5f/Hand_Foot_Mouth_Disease_Adult_36Years.jpg
Hand foot and mouth disease in an adult.

Image 89: https://www.stayathomemum.com.au/wp-content/uploads/2012/05/Hand-Foot-and-Mouth.jpg
Rashes around the mouth are in a child infected with Hand foot and mouth disease.

Image 90: http://outbreaknewstoday.com/wp-content/uploads/2015/09/600px-HFMD_soft_palete_oropharynx.jpg
Rashes can be seen inside the mouth in a case of HFMD.

Variola (small pox)

Small pox has been eradicated from the world in the 1970s. In the initial stage it presents with fever, sore throat, headache, nausea etc. The rashes appear first on face and then spread to elsewhere. First macules (discoloration) appear that become papules (raised areas) and vesicles (fluid filled papules). This break open and become sores[54, 55].

Variola (small pox) Rash Pictures

Image 91: http://media.dermatologyadvisor.com/images/dsm/ch1431.fig3.jpg
Small pox

Image 92: https://www.globalsecurity.org/wmd/intro/images/smallpox-symptoms-cdc3.jpg
Small pox rash- A closer look

Image 93: https://www.cdc.gov/smallpox/images/sp-hand.jpg
Small pox rash.

Herpes Simplex virus infection

Herpes Simplex viruses are of two types, HSV1 and HSV2 (herpes simplex virus 1 and herpes simplex virus 2). HSV1 generally affects the upper part of the body while HSV2 affects the lower part below umbilicus.

They are vesicles which are very painful and has erythematous base (reddish base). HSV1 most commonly causes lesions around the lips (Herpes labialis). HSV2 is known for its effect causing genital herpes[56].

Herpes Simplex virus infection Rash Pictures

Image 94: http://www.derminstitutemd.com/files/2016/05/herpes_simplex1.jpg
HSV1 infection around the mouth- Herpes Labialis

Image 95: https://www.aad.org/Image%20Library/Main%20navigation/Public%20and%20patients/Diseases%20and%20treatments/Contagious%20skin%20diseases/herpes-simplex_landing.jpg
Herpes labialis

Image 96: https://i.ytimg.com/vi/idQgvFRxAGc/hqdefault.jpg
Herpes simplex rash- A closer look

Chicken pox (Varicella zoster virus (VZV) infection)

Chicken pox or varicella zoster infection is a highly contagious viral disease. This appears as a fever along with rashes in different stages of development.

There can papules, vesicles and scabs that form in different parts of the body including eyes and genitalia. The rashes first appear on the trunk and then spread peripherally to the face and limbs. Even after the disease is cured, the virus remains dormant inside the body in spinal ganglia[57, 58].

Chicken pox (Varicella zoster virus (VZV) infection) Rash Pictures

Image 97: https://propakistani.pk/wp-content/uploads/2017/05/6892503_orig.gif
Chicken pox rashes showing various stages.

Image 98: https://assets.nhs.uk/prod/images/CT3DT9.width-1220.jpg
Chicken pox blisters

Shingles (Herpes Zoster infection, VZV)

Herpes zoster is caused by the same virus that causes Chicken pox, varicella zoster virus. The virus which remained dormant in the spinal ganglia gets reactivated when the body is under stress or when the immunity falls. In contrast to chicken pox, the rashes appear only on one side of the body, that too, only where the particular nerve, in which the virus had hidden in the first instance, distributes.

Associated pain is very severe and is called as neuropathic pain which may remain even after the disappearance of the rash (post herpetic neuralgia) [59, 60].

Shingles (Herpes Zoster infection, VZV) Rash Pictures

Image 99: http://www.healthhype.com/wp-content/uploads/herpeszoster_body.jpg
Herpes zoster infection showing distribution along the spinal nerve.

Image 100: http://www.healthhype.com/wp-content/uploads/shingles_rash.jpg
Shingles infect only one side of the body.

Image 101: https://www.researchgate.net/profile/Mehmet_Demirkol4/publication/266263308/figure/fig2/AS:392157086142465@1470508943041/Fig-3-Preoperative-extraoral-photograph-of-a-patient-with-herpes-zoster-rash-on-the-left.png
Shingles along facial nerve distribution.

Yeast infection

The common yeast infection with rash is diaper rash. This is actually caused by a fungus candida albicans. This organism is always present on our body surfaces and where moisture is present. When the immune system is low it can cause a myriad of infections throughout the body. The diaper rashes occur as reddish macules or patches in the diaper area.

There is no fever associated with this rash. It usually affects children and can affect adults as well, whenever there are areas where moisture remains. This is usually seen under the breasts, arm pits, and groin[61, 62].

Yeast infection Rash Pictures

Image 102: https://img.medscapestatic.com/pi/meds/ckb/99/43199.jpg
Diaper Rash

Image 103: http://www.healthitalk.com/wp-content/uploads/2009/08/039183HB.jpg
Candida infection under the breasts.

Image 104: http://diseasespictures.com/wp-content/uploads/2014/05/Armpit-Rash.jpg
Candida infection- Underarm

Systemic Lupus Erythematosis (SLE)

SLE is an autoimmune disorder (our own immunity attacks our normal cells) in which many of our organ systems are affected. There can be fever associated with rashes and joint pain.

A malar rash (Butterfly rash) seen in case of systemic lupus is redness over the cheeks and nasal bridge. Macules or papules with redness around them may be seen in sun exposed areas[63, 64, 65].

Systemic Lupus Erythematosis (SLE) Rash Pictures

Image 105: https://upload.wikimedia.org/wikipedia/commons/5/52/Lupusfoto.jpg
‘Butterfly rash’ is Systemic lupus erythematosis

Image 106: https://pbs.twimg.com/media/BIF2H2ZCYAA5Xyn.jpg
‘Butterfly rash’ is Systemic lupus erythematosis

Scabies infestation

Sarcoptes scabiei causes this condition by infesting the outer layers of skin. They lay eggs there and causes rashes on the skin with burrows. The rashes itself is very itchy, especially during the nights and can be seen mainly in and around the genitalia, waist, navel, wrist, elbow, knees and in between the fingers [66, 67].

Scabies infestation Rash Pictures

Image 107: http://www.quickcare.org/skin/scabiesrashhand.jpg
Scabies in between the fingers.

Image 108: https://www.healthline.com/hlcmsresource/images/galleries/scabies-bites/642x361_Scabies-Bites_SLIDE_1.jpg
Scabies in the buttock area

Image 109: https://www.healthline.com/hlcmsresource/images/galleries/scabies-bites/642x361_Scabies-Bites_SLIDE_3.jpg
Scabies on hand

Image 110: http://images.drscabies.com/faqs/faqs-scabiesrash.jpg
Scabies on wrist

Hookworm infestation

Hookworm/ Ankylostoma duodenale/ Necator americanus enters the body in larval form. They penetrate the skin, enters into the blood circulation and travel throughout to finally reach the intestines. They grow up there to cause Iron deficiency anaemia by feeding on your blood. At the site of entry, on the skin, they cause rashes[68, 69].

Hookworm infestation Rash Pictures

Image 111: https://usercontent1.hubstatic.com/8857108_f520.jpg
‘Cutaneous larva migrans’- the path through which the larva of hookworm passed under the skin.

Image 112: https://encrypted-tbn0.gstatic.com/images?q=tbn:ANd9GcRpDp1Ay0XO6BpeKXRrC83R-GxsEyAXO-AsCwDU3sKAgzfkRDDp
Dermatitis in hookworm infestation.

Fish allergy

Many individuals have allergy to different food items. One of the common food allergies seen is those to finned fishes (Tuna, salmon etc.) The allergy need not necessarily be present from childhood. It can develop at any part of time. As in cases of allergies, this can present with rashes, abdominal cramps, diarrhoea, stuffed nose, difficulty in breathing or even shock (anaphylactic shock)[70].

Fish allergy Rash Pictures

Image 113: http://allergy-symptoms.org/wp-content/uploads/2015/12/hives-tuna-fish-allergy-symptoms.jpg
Allergic rash due to fish consumption.

Image 114: http://www.howtogetridofstuff.com/wp-content/uploads/2015/06/how-to-get-rid-of-food-allergies.png
Allergic rash

Shellfish allergy

The symptoms in shellfish allergy are same as in case of fish allergy (Tuna, salmon etc.) The difference is in the causative food items such as crabs, shrimps, prawns, lobsters, oysters, mussels, squid, octopus etc. A person, who is allergic to finned fishes, need not be allergic to shell fish necessarily. These can present with rashes, abdominal cramps, diarrhoea, stuffed nose, difficulty in breathing or even shock (anaphylactic shock)[71].

Shellfish allergy Rash Pictures

Image 115: http://www.futuresbeginning.com/shellfish-allergy-rash-pictures-25.jpg
Shell fish allergy can present as hives or urticaria.

Image 116: http://www.pediatricswestchester.com/wp-content/uploads/2016/07/Hives.jpg
Shell fish allergy

Wine allergy

Allergy to wine is not usually due to its alcohol content, but due to other ingredients it may contain. This could be barley, grapes, yeast etc. These can present with rashes, abdominal cramps, diarrhoea, stuffed nose, difficulty in breathing or even shock (anaphylactic shock) [72].

Wine allergy Rash Pictures

Image 117: https://i.ytimg.com/vi/TjyoIu0uFvQ/hqdefault.jpg
A case of allergy due to wine consumption.

Image 118: https://cdn.foodbeast.com/content/uploads/2016/11/allergic-reaction-skin-rash.jpg
Hives seen in a person following wine consumption.


Formula allergy

Protein substances present in the formula milk is what causes the allergic reaction. The formula maybe cow’s milk based, soya milk based or any other. The protein content causes the child’s body to produce antibodies against it.

This results in allergic reaction whenever the formula is given. The child may present with rashes, abdominal cramps, diarrhoea, stuffed nose, difficulty in breathing or even shock (anaphylactic shock) [73, 74].

Formula allergy Rash Pictures

Image 119: https://i2.wp.com/www.menuallergie.net/wp-content/uploads/2017/05/cows-milk-allergy-in-babies-symptoms.jpg
Allergic rashes in a baby fed with cow’s milk formula.

Image 120: http://formulacouponsite.com/wp-content/uploads/2012/11/baby-allergy.png
Rashes on face of a baby fed on formula milk.

Rash in Celiac disease

When your body’s immunity react against gluten in certain cereals such as wheat, barley, rye etc. your intestines get affected. It may result in abdominal pain, vomiting and diarrhoea or constipation. It can also cause an itchy, burning rash called as ‘Dermatitis herpetiformis’. They are red bumps which crusts over and could be seen on elbows, knees, back, buttocks and scalp[75, 76].

Rash in Celiac disease Rash Pictures

Image 121: https://theceliacscene.com/wp-content/uploads/2015/12/Dermatitis-herpetiformis-2-300×224.jpg
‘Dermatitis herpetiformis’

Image 122: https://www.coeliac.org.uk/public/images/dermatitis-herpetiformis2.jpg
Dermatitis herpetiformis is seen in celiac disease.

Image 123: https://encrypted-tbn0.gstatic.com/images?q=tbn:ANd9GcSBJ3tfkO8L2qY9tCgkSV5VqzFwTIqe__Wu9XgMLk26T22QE7Q1
Dermatitis herpetiformis

Image 124: https://www.consultant360.com/sites/default/files/1531749.png
Dermatitis herpetiformis

Stevens-Johnson syndrome

Stevens-Johnson syndrome is a serious condition that occurs due to Type 4 Hypersensitivity reaction to skin and mucous membranes. Mostly it is due to unknown causes (Idiopathic). But, it can also be due to certain drugs, infections or malignancy.

Anticonvulsants such as barbiturates, valproic acid, lamotrigine (lamictal), carbamazepine, phenytoin etc , allopurinol, acetaminophen (Tylenol), naproxen, penicillin etc. has been implicated in this condition. Rashes ranging from macules, papules, vesicles and blisters may be seen. Fever with unexplained skin pain, rashes and blistering can occur [77, 78, 79, 80, 81, 82, 83].

Stevens-Johnson syndrome Rash Pictures

Image: 125: https://usercontent2.hubstatic.com/8910683_f496.jpg
Stevens- Johnson Syndrome

Image 126: https://encrypted-tbn0.gstatic.com/images?q=tbn:ANd9GcSodiNZw1PvpSWaYJYBvvA4RSwVfwRZ7fie0PFWMjJl2TSJyZrm
Stevens- Johnson Syndrome

Image 127: https://encrypted-tbn0.gstatic.com/images?q=tbn:ANd9GcR4PWTsQVShnmraeKt6y5JaNYGGbrUKnDHkjkoeMgzpoWdgvI4x_g
Stevens-Johnson syndrome in a child

Drug reactions

Reaction to certain drugs can occur commonly. The reaction may be characterized by rashes, itching, and swelling, breathing difficulties or even anaphylaxis. Penicillins (amoxycillin), sulfa containing antibiotics (Bactrim), anticonvulsants, non-steroidal anti-inflammatory drugs such as aspirin, Tylenol (Acetaminophen), Gabapentin, have all shown drug reactions in many[84, 85].

Drug reactions Rash Pictures

Image 128: https://img.medscapestatic.com/pi/meds/ckb/70/27470tn.jpg
Rashes due to medication.

Image 129: https://images.agoramedia.com/everydayhealth/gcms/Whats-Causing-Your-Skin-Rash-06-RM-1440×810.jpg?width=730
Rashes seen following medication.

Image 130: https://www.healthline.com/hlcmsresource/images/topic_centers/parenting/642x361_Identify_and_Care_for_an_Amoxicillin_Rash.jpg
Rashes following treatment with amoxicillin

Image 131: http://media.infectiousdiseaseadvisor.com/images/dsm/ch2180.fig1.jpg
Rashes appeared following treatment with antibiotics.

Plants causing rash

Plants such as poison ivy, poison sumac, poison oak etc. can cause rash over the skin if it comes in contact. Oil (urushiol) which is present on the plants, can stay on the skin for longer time and cause the itching. They form blisters over the area within a period of 24-72 hours[86, 87, 88].

Plants causing rash pictures

Image 132: https://www.aad.org/Image%20Library/Main%20navigation/Public%20and%20patients/Diseases%20and%20treatments/Itchy%20skin/poison-ivy-symptoms-rash.jpg
Contact dermatitis due to Poison ivy

Image 133:
Contact dermatitis due to Poison Oak

Image 134:
Contact dermatitis due to Poison sumac

Heat Rashes

Miliaria or heat rashes are very common in the children, but can occur in adults too. The sweat glands in the skin when blocked, becomes inflamed and cause the rash. These rashes are slight bumps on the skin, with redness and itching. Generally they are seen in the face, neck, back, trunk and the thighs [89, 90, 91].

Heat Rashes Pictures

Image 135: http://www.newhealthguide.org/images/10405674/PricklyHeat.jpg
Heat rashes on a baby’s chest.

Image 136: http://www.babyrashclinic.com/wp-content/uploads/2015/03/Heat-Rashes-On-Babies-The-Milia-Rubra.jpg
Extensive heat rashes seen in a baby.

Image 137: https://images.medicinenet.com/images/image_collection/pediatrics/miliaria-rubra-prickly-heat-2-8.jpg
Miliaria rubra- A closer look.


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