4 Rashes That are Often Mistaken as Others

Rashes are concerning, especially when they won’t go away or start getting worse. It’s natural to wonder if we became allergic to our body wash or if we're dealing with a serious problem. It’s also tempting to consult Google and self-diagnose the rash.

Dermatologist Jason Hadley has been managing skin rashes for over a decade. After seeing thousands of them, he’s noticed a few misconceptions (and even misdiagnoses) when it comes to skin conditions. Here are four of them to know about.

“A lot of patients visit me believing they have ringworm,” says Dr. Hadley. “Ringworm does happen, but oftentimes, what people think is ringworm is actually an eruption of pityriasis rosea or a case of psoriasis.”

• Pityriasis rosea is a relatively common infection that causes raised red scaly patches on the skin that itch. Pityriasis rosea can affect anyone, but it's more common in adolescents and young adults (age 10 to 35) and flare-ups often happen in the spring.
• Psoriasis is another skin condition that causes thick red skin and silvery scales, typically on the elbows, knees, scalp, and trunk. The cause of psoriasis is not fully understood, but it’s much more common than ringworm.

Dr. Hadley warns, “Pityriasis rosea is viral and ringworm is fungal. This is an example of why you should have a dermatologist take a look: mistreating a viral infection with fungal medication can make problems worse.”

Your child woke up with a lump that hurts. Is it a bug bite? Should you take them to the doctor?

“We have black widows here in Utah, but not too many other spiders that are venomous,” says Dr. Hadley. “Oftentimes, suspected spider bites are either boils or a staph infection,” he says.

Many healthy people carry staph bacteria on their skin or in their noses. When a cut or splinter breaks the skin, the bacteria enters and starts developing an infection. Boils are a painful lump caused when staph bacteria enters through a hair follicle or when a clogged pore becomes infected.

Shingles is caused by the varicella-zoster virus, the same virus that causes chickenpox. Shingles presents as a painful, blistering rash. As the blisters break, they form small sores that dry and crust.

Although shingles is common, it’s frequently mistaken. “Ninety percent of the time when a patient suspects shingles, we find out it's eczema or some type of viral rash,” says Dr. Hadley.

Some telltale signs of shingles are:

• Shingles is usually on one side of the body only
• Shingles is usually in one isolated section
• The rash is usually painful

During the height of the pandemic, Dr. Hadley saw many suspected cases of shingles that turned out to be different viral rash caused by COVID-19. “It's not widely known that rashes can develop after a viral infection, such as varicelliform rash which appears after COVID-19.” Varicelliform rash looks a lot like chickenpox: small round ovals on the skin with bubbles or tiny blisters.

Unlike the other rashes mentioned, poison ivy is one that Utahn’s don’t suspect they have, but frequently do. “We have lots of poison ivy along our mountainsides: near shaded areas and water sources,” says Dr. Hadley.

There are a couple reasons why poison ivy rash is confusing. First, symptoms may not appear until 5-7 days after contact. “People ask ‘Where did I get poison ivy? I’ve been at work all day,’ not realizing they got it last weekend while hiking,” he says.

Another confusing thing about poison ivy is that it doesn’t always look like you’d expect. “In the spring, the leaves may not be fully formed but the plant is still poisonous. And in fall, poison ivy is really pretty. It turns bright orange, yellow, or red. But don’t go near it!”

Poison ivy can self-resolve over one to two months, but living with it is miserable. If you have an itchy, painful rash on your limbs, visit a dermatologist who can resolve the irritation quickly and effectively.

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Dr. Jason Hadley is a board-certified Dermatologist practicing at Ogden Clinic Bountiful. In addition to his clinical interest in rashes, Dr. Hadley also enjoys skin cancer prevention, managing acne, and restoring quality of life for his patients. If you're living with a rash or another concerning skin condition, schedule a visit with Dr. Hadley here.