Possible Causes of Painful Skin Rash

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Possible Causes of Painful Skin Rash

Question:

I have a red irritation on my neck. It feels like I burnt myself but I have not. What can it be?

Answer:

Without seeing the rash, the cause that comes to mind first is a contact dermatitis. Something that touched the skin of your neck likely caused either a direct irritation or an allergic reaction. Irritant contact dermatitis tends to cause the burning sensation. Often, people have some itching, too. An allergy usually results in more intense itching.

Other possibilities include:

• A scrape, such as a rug burn

• Localized "sunburn." (This is called photosensitive eruption.) Something gets on your skin that reacts with sunlight. (Lime juice can do this.) Perfumes also can cause a photosensitive eruption.

• Shingles (herpes zoster). The rash usually appears after the pain has been present for one to three days.

• A bacterial or fungal skin infection in the early stages

I would start by considering what may have touched your skin before the irritation started – a necklace, perfume, a metal button on a shirt collar, etc. If the symptoms are getting worse, contact your doctor.

Howard LeWine, M.D., is chief editor of Internet Publishing at Harvard Health Publications. He is recognized as an outstanding clinician and teacher and is a recipient of the Internal Medicine Teacher of the Year award at Brigham and Women's Hospital. Dr. LeWine continues to practice Internal Medicine; most recently he became a hospitalist after practicing primary care for over 20 years.

Last updated:	July 20, 2009