Non-blanching Rash: Is It Serious? Causes In Adults And Children

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Medical News TodaySubscribeCauses for a non-blanching rash in adults and children

Medically reviewed by Susan Bard, MD — Written by Amanda Barrell on January 28, 2021

Pictures
What are they?
Are they serious?
Causes in adults
Causes in children
Diagnosis and treatment
Summary

A non-blanching rash does not fade under pressure. Rashes of this kind are a result of bleeding underneath the skin. While they are not always serious, they can sometimes indicate severe conditions, such as meningitis or sepsis.

In this article, we will explain what a non-blanching rash is and how to identify one. We will also look at some of the most common causes in children and adults, diagnosis, and potential treatment.

Pictures

What are non-blanching rashes?

Non-blanching rashes are skin lesions that do not fade when a person presses on them. They occur due to bleeding beneath the surface of the skin.

By contrast, blanching rashes fade or turn white when a person applies pressure to them.

To tell the difference between the two, a person can press a drinking glass onto the affected area. If the marks are still visible through the glass, it means that a person has a non-blanching rash.

Are they serious?

Sometimes, a non-blanching rash can be a sign of meningitis or sepsis, which are serious conditions. These rashes may occur anywhere on the body.

However, it is worth noting that there are many different reasons for non-blanching rashes.

A person should seek emergency medical attention if they have a non-blanching rash and any of the following symptoms:

fever
vomiting
severe headache
pain in the limbs, joints, or muscles
shivering
cold feet or hands
a feeling of doom or sudden fear of death
pale or mottled skin
stiff neck
sensitivity to bright light
sleepiness or difficulty waking up
confusion
seizures

Causes in adults

Below, we list potential causes for a non-blanching rash in adults.

Causes for a non-blanching rash with no other symptoms

According to a 2020 article, triggers for a non-blanching rash with no other symptoms can include:

forceful coughing or vomiting
injury
medication side effects
allergy

Causes with accompanying symptoms

Health issues that can cause a non-blanching rash with other symptoms include:

Vasculitis

Autoimmune diseases occur when the body mistakenly attacks its own tissues and organs. Autoimmunity can cause some forms of vasculitis, which damages the blood vessels.

There are many types of vasculitis that affect people in different ways. However, some common symptoms include:

rashes
fevers
unexplained weight loss
rapid heartbeat
tiredness
body aches and pains
joint inflammation

Depending on the type and severity of the condition, a person’s eyes, sinuses, lungs, kidneys, and nervous system may also become affected.

Henoch-Schönlein purpura

Henoch-Schönlein purpura (HSP) occurs due to swelling of the body’s small blood vessels. This type of vasculitis is rare in adults. Sometimes, HSP appears after an infection, such as a cold or chickenpox, or after an insect bite.

Symptoms include:

red or purple non-blanching rash on the buttocks, legs, and feet
sore, swollen joints
stomach pain
nausea
vomiting
bloody stools

HSP generally should not be a cause for concern. However, sometimes it can lead to complications, such as kidney damage. A person should speak with a doctor if they suspect they may have HSP.

Idiopathic thrombocytopenia

Idiopathic thrombocytopenia (ITP) is a bleeding disorder that stops the blood from clotting properly. It causes bleeding inside the body and underneath the skin, which presents as non-blanching rashes.

These rashes might look similar to small red or purple dots or larger red or brown bruises.

Other symptoms include:

nosebleeds
gum bleeding
heavier-than-normal menstrual periods

ITP may be acute, meaning that symptoms have been present for up to 6 months, or chronic, where symptoms persist for longer periods of time or constantly recur.

Meningitis

Some infections can cause meningitis, which is a swelling of the brain and spinal cord. The main types of this condition are viral meningitis and bacterial meningitis.

Meningitis symptoms include:

non-blanching rash
fever
headache
stiff neck
sensitivity to light
confusion

Meningitis is a very serious medical condition. If a person is experiencing the above symptoms, they should seek emergency medical attention.

Sepsis

Sepsis is an extreme response from the body’s immune system to an infection.

In addition to a non-blanching rash, sepsis can cause:

fever, chills, and shivering
a rapid pulse, known as tachycardia
breathing difficulties
clammy or sweaty skin
extreme pain or discomfort
redness and swelling around a wound
dizziness
confusion
loss of consciousness

Sepsis can be life threatening, and a person experiencing this condition requires urgent medical attention.

Causes in children

Many of the causes for non-blanching rashes in adults also affect children, including:

HSP

HSP is the most common form of vasculitis in children. Most cases of HSP occur in children aged 3–15 years, and it tends to develop in males more often than in females.

Most cases of HSP in children are mild and resolve on their own.

Other forms of vasculitis

Many other forms of vasculitis can also affect children. They are less common than HSP, but they can be more serious. Examples include:

Kawasaki disease
Polyarteritis nodosa
Takayasu’s arteritis

Doctors do not always know what causes more serious forms of vasculitis in children, but some, such as Kawasaki disease, can develop following an infection.

ITP

While both adults and children can develop ITP, children tend to experience the short-term version of the condition. It usually goes away within a few weeks.

Meningitis

Babies are more likely to develop bacterial meningitis than other age groups. Symptoms, which can also be more difficult to spot in babies, include:

being slow or inactive
feeling irritable
vomiting
feeding poorly

In serious cases, the baby might have seizures.

Sepsis

Infants under 12 months of age are also more likely to develop sepsis than other age groups.

Diagnosis and treatment

Many different factors can cause a non-blanching rash. Doctors may ask about symptoms and what the person was doing before the rash occurred. They may also perform blood tests.

Vasculitis

There are numerous tests a doctor may recommend to diagnose vasculitic conditions, including:

blood tests
urine tests
medical imaging, such as a CT scan
an angiogram, which is an X-ray of the blood vessels
a biopsy, which involves a doctor taking a small amount of tissue for examination

Treatment for vasculitis can vary depending on the type of the disease. However, autoimmune vasculitis is a long-term condition that requires ongoing management and use of medication. A person may require drugs, such as methotrexate or prednisone, to suppress the immune system.

HSP

While there is no medical test for HSP, doctors will usually ask the person about their symptoms and make a diagnosis based on the answers.

Most people with HSP will get better without treatment. In the meantime, doctors advise:

taking rest
drinking plenty of fluids
taking over-the-counter pain medicines, such as acetaminophen (Tylenol)

In rare cases, HSP can lead to severe symptoms. If this occurs, a person may need to stay in the hospital.

ITP

Doctors will diagnose ITP by asking questions about a person’s symptoms and past illnesses and examining their skin. Healthcare professionals will also carry out blood tests to see how well the blood can clot.

Mild cases of ITP in adults usually get better without treatment. Doctors might prescribe steroids or medicines such as rituximab or immune globulin to promote blood clotting.

If bleeding is severe, doctors might prescribe steroids. However, not everyone with ITP needs treatment.

Meningitis

If a healthcare professional suspects a person may have meningitis, they will take samples of their blood or cerebrospinal fluid, which is the fluid in the spinal cord, to find out what is causing the infection.

They will then use antiviral medications to treat viral meningitis, or antibiotics to treat bacterial meningitis.

Sepsis

Doctors will usually take a person’s temperature, blood pressure, heart rate, and breathing rate. They will also take a blood sample to test for signs of an infection.

Standard treatment includes antibiotics. Doctors will keep a close eye on the individual to make sure all their organs are getting enough healthy blood.

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Summary

Non-blanching rashes occur due to bleeding under the skin. Unlike other rashes, they do not fade under pressure. A person can determine whether a rash is non-blanching by holding a glass against the skin and pressing down.

A number of factors can cause a non-blanching rash. While many are not serious, some require urgent medical care. A person with symptoms of meningitis or sepsis should call 911 immediately.

Dermatology

How we reviewed this article:

SourcesMedical News Today has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Bactertial meningitis. (2019).https://www.cdc.gov/meningitis/bacterial.html#risk
Henoch-Schonlein purpura. (2017).https://www.healthychildren.org/English/health-issues/conditions/skin/Pages/Henoch-Schonlein-Purpura.aspx
Henoch-Schonlein purpura. (2018).https://rarediseases.info.nih.gov/diseases/8204/henoch-schonlein-purpura
Immune thrombocytopenia. (n.d.).https://www.nhlbi.nih.gov/health-topics/immune-thrombocytopenia
McGrath, A., et al. (2020). Petechiae.https://www.ncbi.nlm.nih.gov/books/NBK482331/
Meningitis. (2020).https://www.cdc.gov/meningitis/index.html
Saving patients from sepsis. (2016).https://www.cdc.gov/media/dpk/diseases-and-conditions/sepsis/dpk-sepsis.html#:~:text=Those%20considered%20to%20be%20high,conditions%20(such%20as%20diabetes).
Symptoms of vasculitis. (n.d.).https://www.hopkinsvasculitis.org/vasculitis/symptoms-vasculitis/
Treatment and recovery. (2019).https://www.nhs.uk/conditions/sepsis/treatment-and-recovery/
Vasculitis in children. (n.d.).https://www.vasculitis.org.uk/living-with-vasculitis/vasculitis-in-children
What is sepsis? (2020).https://www.cdc.gov/sepsis/what-is-sepsis.html

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Medically reviewed by Susan Bard, MD — Written by Amanda Barrell on January 28, 2021

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Pictures

What are non-blanching rashes?

Are they serious?

Causes in adults

Causes for a non-blanching rash with no other symptoms

Causes with accompanying symptoms

Vasculitis

Henoch-Schönlein purpura

Idiopathic thrombocytopenia

Meningitis

Sepsis

Causes in children

HSP

Other forms of vasculitis

ITP

Meningitis

Sepsis

Diagnosis and treatment

Vasculitis

HSP

ITP

Meningitis

Sepsis

Summary

How we reviewed this article:

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