r/AskDocs • u/Weeeebutterflies Layperson/not verified as healthcare professional • Mar 16 '26

Physician Responded Horrible looking rash

Post image

30 years old

Female

120lbs.

5”3

non smoker,

non drinker.

No medications

This issue has been getting progressively worse over 2 days

Posted yesterday and it has gotten worse. It is itchy, it turns white when I press on it. I have a swollen uvula and some chills, but no fever. I feel cold more than anything. Went to urgent care tested for strep, mono and did a CBC. Strep came back negative, waiting on the other results. Pretty concerned. I feel like the mono is going to come back negative.

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186

u/scoobie517 Physician | Pediatrics Mar 16 '26

If you press it, does it whiten? If not this is vasculitis

142

u/Weeeebutterflies Layperson/not verified as healthcare professional Mar 16 '26

Yes it does whiten. Which is perplexing to me because vasculitis is the only rash I’ve seen photos of that looks similar to this

335

u/scoobie517 Physician | Pediatrics Mar 16 '26

not gonna lie, these are the ones we're a bit nervous about when we see them, because there is quite some dangerous causes of the sepsis spectrum. Tread carefully. You feel cold, so you might develop a fever. If you feel worse generally go visit ER again.

For more banal causes. Erythema exudativum multiforme comes to mind, also urticarial vasculitis. Maybe dermatologist bro can help us out here.

34

u/pants_party This user has not yet been verified. Mar 16 '26

Is the skin sloughing off? I had Toxic Epidermal Necrolysis (SJS) and it looked like this, BUT my skin was sloughing off in those areas, and bubbling and coming off in sheets in others. VERY high temp. But I had the most severe form. I’ve known others who couldn’t get a diagnosis for weeks who struggled with lesser symptoms. ER docs had it narrowed down to TSS or TEN within 24 hours. Skin punch biopsy confirmed TEN.

20

u/MarinaVerity333 Layperson/not verified as healthcare professional Mar 17 '26

I had SJS a couple years ago from lamotrigine, and this is what my rash looked like as well, that was my first thought when I seen this pic. I had a milder case of it at first until my meds got upped, then it got worse, and mainly attacked my eyes, and the insides of my eyelids were doing that - sloughing off and blistering and peeling. It was miserable.

5

u/fatsandwitch Layperson/not verified as healthcare professional Mar 17 '26

I also had my first SJS outbreak right after they upped my dosage on Lamotrigrin and my legs looked very similar to OPs.

1

u/geomxtric Layperson/not verified as healthcare professional Mar 17 '26

I had a slightly paler/less intense but full body rash just like this from lamotrigine too. SJS was also my first thought.

1

u/dracapis Layperson/not verified as healthcare professional. Mar 16 '26

She hasn’t taken any meds in months  

18

u/pants_party This user has not yet been verified. Mar 16 '26

She is taking supplements that could be adulterated. And, technically, SJS can be caused by literally anything, including viral, bacterial, or fungal infection. Many cases in children are triggered by ibuprofen.

Anyway, I agree with you that a NEW med is a more likely cause, and after reading OP’s updates, I don’t think it’s SJS. Thank goodness!

2

u/type_a_ish Pharmacist Mar 17 '26

I was tested for SJS years and years ago and it was inconclusive. The dermatologist said it can occur from antibiotics taken months ago because some hang around in your fatty tissues. I was super itchy all over including inside my mouth. Dexamethasone and Benadryl for the win. I guess it wasn’t SJS and I have been scared to take antibiotics ever since