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Erythema – Causes, Symptoms and Treatment

Erythema is a redness of the skin caused by increased blood flow in the superficial capillaries. It can result from infections, allergies, inflammation, or physical stimuli.

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Things worth knowing about "Erythema"

Erythema is a redness of the skin caused by increased blood flow in the superficial capillaries. It can result from infections, allergies, inflammation, or physical stimuli.

What is Erythema?

Erythema refers to a superficial reddening of the skin caused by dilation of the small blood vessels (capillaries) in the dermis. The term is derived from the Greek word erythros, meaning red. The redness can be localized or widespread and typically blanches (turns white) when pressure is applied with a finger – a key feature that distinguishes erythema from skin hemorrhages such as petechiae or purpura.

Causes

Erythema can arise from a wide range of causes, including:

Infections: Bacterial, viral, or fungal infections can cause skin redness, such as erysipelas (a bacterial skin infection) or erythema migrans in Lyme disease.
Allergic reactions: Contact allergies, drug hypersensitivity, or food allergies can trigger allergic erythema.
Physical stimuli: Sun exposure (sunburn), heat, cold, or mechanical pressure can cause temporary skin redness.
Inflammatory skin conditions: Diseases such as rosacea, lupus erythematosus, or seborrheic dermatitis are frequently associated with erythema.
Toxic reactions: Exposure to irritants or certain chemicals can lead to irritant contact erythema.
Systemic diseases: Internal conditions such as autoimmune diseases or certain malignancies may also manifest with skin redness.

Symptoms and Clinical Presentation

Erythema presents as a red to bright-red discoloration of the skin, which may feel warm to the touch and can occasionally appear slightly swollen. Depending on the underlying cause, the following accompanying symptoms may occur:

Itching (pruritus)
Burning or tightness of the skin
Scaling or blistering (depending on the underlying condition)
General symptoms such as fever or malaise in infection-related erythema

Key Clinical Forms

Erythema migrans: A characteristic expanding ring-shaped rash associated with Lyme disease, spreading outward from the site of a tick bite.
Erythema multiforme: Target-shaped lesions typically triggered by infections or medications.
Erythema nodosum: Tender, red nodules usually located on the shins, indicating a systemic inflammatory response.
Erythema toxicum neonatorum: A harmless, self-limiting rash occurring in newborns within the first days of life.

Diagnosis

The diagnosis of erythema is primarily based on clinical skin examination. The physician assesses the location, shape, extent, and associated features of the redness. Additional investigations to determine the underlying cause may include:

Blood tests (e.g., inflammatory markers, antibodies)
Allergy testing (patch test, prick test)
Skin biopsy for unclear or persistent cases
Microbiological swabs when an infection is suspected

Treatment

Treatment of erythema is always directed at the underlying cause:

Infection-related erythema is treated with antibiotics, antivirals, or antifungals, depending on the pathogen involved.
Allergic erythema requires avoidance of the triggering allergen and may be managed with antihistamines or corticosteroids.
Inflammatory erythema is treated with topical or systemic anti-inflammatory agents depending on severity.
Physically induced redness often resolves on its own once the triggering stimulus is removed; cooling compresses or soothing skin care products can provide relief.

Persistent, spreading, or systemically accompanied skin redness should always be evaluated by a healthcare professional.

References

Wolff, K., Johnson, R.A., Saavedra, A.P. - Fitzpatrick's Color Atlas and Synopsis of Clinical Dermatology. McGraw-Hill Education, 8th edition (2017).
Braun-Falco, O. et al. - Dermatology. Springer Verlag, 3rd edition (2009).
World Health Organization (WHO) - Skin conditions: overview and classification. WHO Technical Report (2020). Available at: https://www.who.int

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