Erupciones Generalizadas y Localizadas

Las erupciones son un grupo de enfermedades que provocan una coloración y textura anormales en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la piel. Las etiologías son numerosas, pero pueden incluir irritación, alérgenos, infecciones o condiciones inflamatorias. Las erupciones que se presentan en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum una sola zona del cuerpo se denominan erupciones localizadas. Las erupciones generalizadas se producen de forma difusa por todo el cuerpo. Las erupciones pueden clasificarse por su distribución, configuración y morfología. El diagnóstico suele ser clínico y se basa en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria antecedentes del paciente y en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria hallazgos del examen físico. El tratamiento depende de la identificación de la condición correcta y varía dependiendo de la etiología.

Last updated: Dec 15, 2025

Editorial responsibility: Stanley Oiseth, Lindsay Jones, Evelin Maza

Contents

Descripción General

Clasificación

Presentación Clínica y Diagnóstico

Tratamiento

Comparación de las Erupciones Generalizadas

Comparación de las Erupciones Localizadas más Comunes

Referencias

Descripción General

Definición

Una erupción es un cambio anormal en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el color o la textura de la piel.

Epidemiología

Una de las afecciones más comunes enfrentadas por los LOS Neisseria médicos de atención primaria
En EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum 2016, 1 de cada 4 personas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum Estados Unidos (84,5 millones) se vio afectada por una enfermedad de la piel.
1 de cada 3 personas necesitó una evaluación dermatológica.
Las erupciones maculopapulares son la erupción generalizada más frecuente (95%).
Los LOS Neisseria errores de diagnóstico en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum las erupciones generalizadas son frecuentes.

Etiología

La lista de etiologías de las erupciones es larga, pero puede incluir irritantes, alérgenos, infecciones y afecciones inflamatorias.

Clasificación

Las erupciones se describen y clasifican en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum función de determinadas características, lo que puede ayudar a establecer un diagnóstico diferencial al AL Amyloidosis evaluar a un paciente.

Configuración

La configuración se refiere a la forma o el contorno de las lesiones.

Circinada: redonda, circular
Arciforme: forma un círculo parcial
Lineal: parece recta
Serpiginosa: aspecto serpenteante
Anular: redonda o circular con claro central
En EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum forma de diana: una serie de anillos concéntricos
Girada: una serie de arcos de conexión
Zosteriforme: parece afectar un dermatoma

Configuraciones de la erupción — Visualización de diferentes configuraciones de erupción
Imagen por Lecturio.

Morfología

La morfología se basa en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el tamaño y la consistencia de las lesiones.

Lesiones planas:
- Mácula: lesión no palpable < 1 cm de diámetro
- Parche: lesión no palpable > 1 cm de diámetro
Lesiones elevadas:
- Pápula: lesión elevada < 1 cm de diámetro
- Placa: lesión elevada y plana > 1 cm de diámetro
- Nódulo: lesión profunda, sólida o quística, elevada > 1 cm de diámetro
- Roncha: placa irregular, edematosa, elevada y transitoria
Lesiones ampollosas:
- Vesícula: ampolla llena de líquido claro, < 1 cm de diámetro
- Bulla Bulla Blister filled with fluid, > 1 cm diameter Generalized and Localized Rashes: ampolla llena de líquido, > 1 cm de diámetro
- Pústula: ampolla llena de pus
Destrucción de la epidermis Epidermis The external, nonvascular layer of the skin. It is made up, from within outward, of five layers of epithelium: (1) basal layer (stratum basale epidermidis); (2) spinous layer (stratum spinosum epidermidis); (3) granular layer (stratum granulosum epidermidis); (4) clear layer (stratum lucidum epidermidis); and (5) horny layer (stratum corneum epidermidis). Skin: Structure and Functions:
- Erosión o abrasión: pérdida de espesor parcial de la epidermis Epidermis The external, nonvascular layer of the skin. It is made up, from within outward, of five layers of epithelium: (1) basal layer (stratum basale epidermidis); (2) spinous layer (stratum spinosum epidermidis); (3) granular layer (stratum granulosum epidermidis); (4) clear layer (stratum lucidum epidermidis); and (5) horny layer (stratum corneum epidermidis). Skin: Structure and Functions
- Fisura: una grieta o hendidura que se extiende hacia la dermis Dermis A layer of vascularized connective tissue underneath the epidermis. The surface of the dermis contains innervated papillae. Embedded in or beneath the dermis are sweat glands; hair follicles; and sebaceous glands. Skin: Structure and Functions
- Úlcera: pérdida de espesor total de la epidermis Epidermis The external, nonvascular layer of the skin. It is made up, from within outward, of five layers of epithelium: (1) basal layer (stratum basale epidermidis); (2) spinous layer (stratum spinosum epidermidis); (3) granular layer (stratum granulosum epidermidis); (4) clear layer (stratum lucidum epidermidis); and (5) horny layer (stratum corneum epidermidis). Skin: Structure and Functions que se extiende hacia la dermis Dermis A layer of vascularized connective tissue underneath the epidermis. The surface of the dermis contains innervated papillae. Embedded in or beneath the dermis are sweat glands; hair follicles; and sebaceous glands. Skin: Structure and Functions

Morfología de la erupción — Visualización de las diferentes morfologías de las erupciones
Imagen por Lecturio.

Diagrama de flujo de la morfología de la erupción — Esquema para ayudar a diferenciar las distintas morfologías en función de su tamaño y características
Imagen por Lecturio.

Small, flat macules due to rubella — Máculas pequeñas y planas debidas a la rubéola
Image: “Rubella” por CDC. Licencia: Dominio Público

Large patches of hypopigmentation in vitiligo — Máculas pequeñas y planas debidas a la rubéola
Image: “Rubella” por CDC. Licencia: Dominio Público

Características secundarias

Costra: exudado seco en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la piel
Escama: escamas o placas de epidermis Epidermis The external, nonvascular layer of the skin. It is made up, from within outward, of five layers of epithelium: (1) basal layer (stratum basale epidermidis); (2) spinous layer (stratum spinosum epidermidis); (3) granular layer (stratum granulosum epidermidis); (4) clear layer (stratum lucidum epidermidis); and (5) horny layer (stratum corneum epidermidis). Skin: Structure and Functions desecada
Liquenificación: engrosamiento coriáceo de la piel con marcas cutáneas exageradas
Excoriación: erosiones cutáneas lineales, a menudo causadas por el rascado
Edema Edema Edema is a condition in which excess serous fluid accumulates in the body cavity or interstitial space of connective tissues. Edema is a symptom observed in several medical conditions. It can be categorized into 2 types, namely, peripheral (in the extremities) and internal (in an organ or body cavity). Edema: hinchazón del tejido
Cicatriz: desarrollo de tejido fibroso tras una lesión

Demonstration of an overlying crust — Una costra superpuesta

Imagen: “Diabetic dermopathy (“shin spots”) and diabetic bullae (“bullosis diabeticorum”) at the same patient” por Brzezinski P, Chiriac AE, Pinteala T, Foia L, Chiriac A. Licencia: CCC BY 3.0

Scale on a herald patch of pityriasis rosea — Una costra superpuesta

Imagen: “Diabetic dermopathy (“shin spots”) and diabetic bullae (“bullosis diabeticorum”) at the same patient” por Brzezinski P, Chiriac AE, Pinteala T, Foia L, Chiriac A. Licencia: CCC BY 3.0

Distribución

Localizada: Las lesiones se limitan a una zona específica.
Generalizada: Las lesiones están dispersas por todo el cuerpo.
Simétrica: afecta de forma similar a ambos lados del cuerpo
Asimétrico: unilateral o afecta a ambos lados del cuerpo de forma diferente
Discreta: lesiones separadas y distintas
Agrupada: grupos de lesiones
Confluyente (coalescente): Las lesiones más pequeñas se fusionan.
Plano de clivaje: Las lesiones se disponen a lo largo de las líneas de tensión de la piel.

Presentación Clínica y Diagnóstico

El diagnóstico de muchas enfermedades es puramente clínico y se basa en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la historia clínica y el examen físico del paciente.

Antecedentes

Inicio (incluyendo el lugar de inicio)
Tiempo de evolución:
- Aguda o crónica
- Recaída-remisión
Progresión
Factores agravantes y atenuantes
Síntomas asociados:
- Fiebre
- Prurito
- Dolor Dolor Inflammation
- Malestar
- Tos TOS Thoracic outlet syndrome (TOS) is a broad term used for a spectrum of syndromes related to the general region of the thoracic outlet, which involves the compression or irritation of elements of the brachial plexus, subclavian artery, or subclavian vein. Thoracic Outlet Syndrome
Otros antecedentes pertinentes:
- Alergias
- Viajes recientes
- Exposición a insectos, plantas o animales
- Antecedentes ocupacionales
- Nuevos productos para el hogar
- Exposición a drogas
- Contacto con otros enfermos
- Enfermedades crónicas
- Antecedentes sexuales

Tabla: Resumen de posibles afecciones según los LOS Neisseria antecedentes del paciente
Antecedentes del paciente	Enfermedad asociada
Enfermedad crónica	Dermatitis Dermatitis Any inflammation of the skin. Atopic Dermatitis (Eczema) herpetiforme Dermatitis Dermatitis Any inflammation of the skin. Atopic Dermatitis (Eczema) seborreica
Contacto con personas enfermas	5ta enfermedad Meningococemia Rubeola Rubeola Measles (also known as rubeola) is caused by a single-stranded, linear, negative-sense RNA virus of the family Paramyxoviridae. It is highly contagious and spreads by respiratory droplets or direct-contact transmission from an infected person. Typically a disease of childhood, measles classically starts with cough, coryza, and conjunctivitis, followed by a maculopapular rash. Measles Virus Roséola Rubeola Rubeola Measles (also known as rubeola) is caused by a single-stranded, linear, negative-sense RNA virus of the family Paramyxoviridae. It is highly contagious and spreads by respiratory droplets or direct-contact transmission from an infected person. Typically a disease of childhood, measles classically starts with cough, coryza, and conjunctivitis, followed by a maculopapular rash. Measles Virus Fiebre escarlatina Varicela
Exposición a drogas	Lupus Erupción por medicamentos Urticaria Urticaria Urticaria is raised, well-circumscribed areas (wheals) of edema (swelling) and erythema (redness) involving the dermis and epidermis with associated pruritus (itch). Urticaria is not a single disease but rather is a reaction pattern representing cutaneous mast cell degranulation. Urticaria (Hives) Síndrome de Stevens-Johnson
Exposición ocupacional o ambiental	Dermatitis Dermatitis Any inflammation of the skin. Atopic Dermatitis (Eczema) de contacto
Exposición a insectos y artrópodos	Picaduras de insectos Enfermedad de Lyme Rickettsiosis variceliforme o vesicular (fiebre vesiculosa) Fiebre maculosa de las Montañas Rocosas Escabiosis
Síntomas sistémicos recientes	5ta enfermedad Exantema agudo del VIH Enfermedad de Kawasaki Meningococemia Roséola Rubeola Rubeola Measles (also known as rubeola) is caused by a single-stranded, linear, negative-sense RNA virus of the family Paramyxoviridae. It is highly contagious and spreads by respiratory droplets or direct-contact transmission from an infected person. Typically a disease of childhood, measles classically starts with cough, coryza, and conjunctivitis, followed by a maculopapular rash. Measles Virus Rubeola Rubeola Measles (also known as rubeola) is caused by a single-stranded, linear, negative-sense RNA virus of the family Paramyxoviridae. It is highly contagious and spreads by respiratory droplets or direct-contact transmission from an infected person. Typically a disease of childhood, measles classically starts with cough, coryza, and conjunctivitis, followed by a maculopapular rash. Measles Virus Fiebre escarlatina Varicela
Antecedentes sexuales	Exantema agudo del VIH Sífilis secundaria Gonorrea diseminada
Viajes recientes	Picaduras de insectos Enfermedad de Lyme Rickettsiosis variceliforme o vesicular (fiebre vesiculosa) Fiebre maculosa de las Montañas Rocosas

VIH: virus de la inmunodeficiencia humana

Examen físico

Debe realizarse un examen completo de la piel.

Características:
- Número de lesiones
- Configuración y bordes
- Morfología
- Color
- Presencia de escamas o costras
Distribución:
- Difusa o localizada
- Simétrica o asimétrica
- Dermatomal Dermatomal Dermatologic Examination
- Agrupados o en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum conjunto
- Afectación de la mucosa
- Sitios atípicos (e.g., palmas de manos y pies)
Palpación de lesiones:
- Elevadas
- Planas
- Cambios de textura
- Induración
- Blanqueamiento con digitopresión
En EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria pacientes con bullas, compruebe el signo de Nikolsky:
- Extensión de las ampollas o desprendimientos de la piel al AL Amyloidosis aplicar presión
- Demuestra el desprendimiento de la piel
En EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria pacientes con placas, compruebe el signo de Auspitz: hemorragia puntual tras el raspado de las placas
Otros hallazgos del examen físico que deben evaluarse:
- Signos vitales
- Linfadenopatía
- Conjuntivitis
- Faringitis
- Soplo cardíaco
- Hepatoesplenomegalia
- Hinchazón de las articulaciones
- Déficits neurológicos

Exámenes de laboratorio

Se puede realizar mayores pruebas diagnósticas si los LOS Neisseria antecedentes y el examen físico no proporcionan suficientes pistas para el diagnóstico. El diagnóstico diferencial dictará qué estudios deben efectuarse.

Biopsia con examen microscópico:
- No existen guías ampliamente aceptadas con indicaciones para la biopsia de piel.
- La inmunofluorescencia puede ser útil.
Se indican pruebas de laboratorio si es que hay síntomas sistémicos.
- Hemograma completo → evaluar si hay eosinofilia, neutrofilia o trombocitopenia
- Panel metabólico básico y panel de función hepática → evaluar la afectación sistémica renal y hepática
- ANA → una buena prueba inicial si se considera una etiología autoinmune
- Pruebas serológicas para diversas causas infecciosas
Pruebas de alergia:
- Pruebas de parches
- Pruebas de punción cutánea
- Estudios de IgE IgE An immunoglobulin associated with mast cells. Overexpression has been associated with allergic hypersensitivity. Immunoglobulins: Types and Functions en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum suero

Tratamiento

El tratamiento de una erupción depende de la enfermedad subyacente. Muchas erupciones se autolimitan y pueden no requerir ningún tratamiento.

Tratamiento básico:
- Identificar y evitar los LOS Neisseria factores agravantes.
- Terapias de soporte:
  - Baños de baja temperatura
  - Jabones suaves
  - Emolientes
  - Hidratación de la piel
Manejo del dolor Dolor Inflammation y el prurito:
- Paracetamol paracetamol Acetaminophen is an over-the-counter nonopioid analgesic and antipyretic medication and the most commonly used analgesic worldwide. Despite the widespread use of acetaminophen, its mechanism of action is not entirely understood. Acetaminophen
- AINE
- Antihistamínicos
Para las afecciones inflamatorias:
- Debe descartarse infección.
- Esteroides tópicos:
  - Hidrocortisona
  - Triamcinolona
  - Clobetasol Clobetasol A derivative of prednisolone with high glucocorticoid activity and low mineralocorticoid activity. Absorbed through the skin faster than fluocinonide, it is used topically in treatment of psoriasis but may cause marked adrenocortical suppression. Glucocorticoids
  - Betametasona
- Esteroides sistémicos
Para causas infecciosas:
- Antibióticos
- Antifúngicos
- Antivirales
Tratamiento adecuado de las enfermedades sistémicas subyacentes

Comparación de las Erupciones Generalizadas

Condiciones no infecciosas

**Tabla: Resumen de las erupciones generalizadas no infecciosas más comunes**
Entidad	Características	Diagnóstico	Tratamiento
Dermatitis Dermatitis Any inflammation of the skin. Atopic Dermatitis (Eczema) atópica ( eczema Eczema Atopic dermatitis, also known as eczema, is a chronic, relapsing, pruritic, inflammatory skin disease that occurs more frequently in children, although adults can also be affected. The condition is often associated with elevated serum levels of IgE and a personal or family history of atopy. Skin dryness, erythema, oozing, crusting, and lichenification are present. Atopic Dermatitis (Eczema))	Reacción de hipersensibilidad tipo IV Va VA Ventilation: Mechanics of Breathing desde el eritema hasta la liquenificación y la eritrodermia Parches o placas escamosas Prurito La distribución es típicamente sobre las superficies flexoras.	Diagnóstico clínico Niveles de IgE IgE An immunoglobulin associated with mast cells. Overexpression has been associated with allergic hypersensitivity. Immunoglobulins: Types and Functions en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum suero Pruebas de punción cutánea Pruebas de parches	Evitar los LOS Neisseria desencadenantes Terapia sintomática Emolientes Corticoides tópicos Inhibidores tópicos de la calcineurina Fototerapia Inmunosupresores
Erupción por medicamentos	A menudo una reacción de hipersensibilidad inmunomediada La gravedad varía desde la urticaria Urticaria Urticaria is raised, well-circumscribed areas (wheals) of edema (swelling) and erythema (redness) involving the dermis and epidermis with associated pruritus (itch). Urticaria is not a single disease but rather is a reaction pattern representing cutaneous mast cell degranulation. Urticaria (Hives) y las erupciones maculopapulares hasta el EM, el SSJ y la NET Las lesiones pueden incluir: Ronchas edematosas Lesiones maculopapulares difusas Lesiones en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum forma de blanco Bullas cutáneas Descamación de la piel y las mucosas Síntomas sistémicos	Diagnóstico clínico La biopsia de piel rara vez es necesaria.	Retirar el medicamento que se sospecha es la causa Terapia sintomática Cuidados de soporte
Pitiriasis rosada	Idiopática Una sola mancha redonda, ovoide, de color salmón (“parche heráldico”) Seguido de un exantema generalizado con escamas Distribución en “árbol de Navidad” en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la espalda Prurito	Diagnóstico clínico	No requiere de intervención Tratamiento sintomático
Liquen plano	Idiopática Enfermedad inflamatoria mediada por células Lesiones planas, papulares, de color púrpura Prurito Incluye los LOS Neisseria genitales, las uñas, el cuero cabelludo y las mucosas	Diagnóstico clínico Biopsia de confirmación	Esteroides tópicos
Psoriasis Psoriasis Psoriasis is a common T-cell-mediated inflammatory skin condition. The etiology is unknown, but is thought to be due to genetic inheritance and environmental triggers. There are 4 major subtypes, with the most common form being chronic plaque psoriasis. Psoriasis	Enfermedad inflamatoria mediada por células Placas bien circunscritas, de color salmón Escamas plateadas Se ve VE Ventilation: Mechanics of Breathing en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el cuero cabelludo y en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum las superficies extensoras	Diagnóstico clínico La biopsia rara vez es necesaria.	Terapia local: Esteroides tópicos Calcitriol Calcitriol The physiologically active form of vitamin d. It is formed primarily in the kidney by enzymatic hydroxylation of 25-hydroxycholecalciferol (calcifediol). Its production is stimulated by low blood calcium levels and parathyroid hormone. Calcitriol increases intestinal absorption of calcium and phosphorus, and in concert with parathyroid hormone increases bone resorption. Parathyroid Glands: Anatomy Retinoides tópicos Fototerapia Terapia sistémica: Metotrexato Ciclosporina Apremilast Apremilast Phosphodiesterase Inhibitors Agentes biológicos

Nota: Aunque la pitiriasis rosada y el liquen plano se consideran idiopáticos, se han asociado a ciertos virus.
EM: eritema multiforme
SSJ: Síndrome de Stevens-Johnson
NET: necrólisis epidérmica tóxica

Erythema and lichenification in the kneefolds of a patient with atopic dermatitis — Eritema y liquenificación en los pliegues de las rodillas de un paciente con dermatitis atópica

Imagen: “Role of the skin microbiome in atopic dermatitis” por Salava A, Lauerma A. Licencia: CC BY 4.0

Edematous wheals suggestive of urticaria. This can be a manifestation of a drug eruption. — Eritema y liquenificación en los pliegues de las rodillas de un paciente con dermatitis atópica

Imagen: “Role of the skin microbiome in atopic dermatitis” por Salava A, Lauerma A. Licencia: CC BY 4.0

Condiciones infecciosas

**Tabla: Resumen de las erupciones infecciosas generalizadas más comunes**
Entidad	Características	Diagnóstico	Tratamiento
Fiebre aftosa o exantema viral de manos, pies y boca	Causada por el coxsackievirus Coxsackievirus Coxsackievirus is a member of a family of viruses called Picornaviridae and the genus Enterovirus. Coxsackieviruses are single-stranded, positive-sense RNA viruses, and are divided into coxsackie group A and B viruses. Both groups of viruses cause upper respiratory infections, rashes, aseptic meningitis, or encephalitis. Coxsackievirus tipo A Vesículas dolorosas de forma ovalada en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum manos, pies, glúteos y mucosa oral Asociada a fiebre	Diagnóstico clínico	Tratamiento sintomático
Roséola (exantema súbito)	Causado por HHV-6 HHV-6 Human herpesvirus (HHV)-6 and HHV-7 are similar double-stranded DNA viruses belonging to the Herpesviridae family. Human herpesviruses are ubiquitous and infections are commonly contracted during childhood. Human Herpesvirus 6 and 7 o HHV-7 HHV-7 Human herpesvirus (HHV)-6 and HHV-7 are similar double-stranded DNA viruses belonging to the Herpesviridae family. Human herpesviruses are ubiquitous and infections are commonly contracted during childhood. Human Herpesvirus 6 and 7 Erupción maculopapular Maculopapular Dermatologic Examination de color rosa Principalmente en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum pecho y abdomen, pero pueden verse afectadas espaldas, cara y extremidades Precedida por fiebre alta y linfadenopatía cervical	Diagnóstico clínico	Tratamiento sintomático
Sarampión	Causado por el virus Virus Viruses are infectious, obligate intracellular parasites composed of a nucleic acid core surrounded by a protein capsid. Viruses can be either naked (non-enveloped) or enveloped. The classification of viruses is complex and based on many factors, including type and structure of the nucleoid and capsid, the presence of an envelope, the replication cycle, and the host range. Virology del sarampión Erupción maculopapular Maculopapular Dermatologic Examination que comienza en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la cara y se extiende al AL Amyloidosis tronco y las extremidades Manchas de Koplik en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la membrana bucal Asociado con fiebre alta, tos TOS Thoracic outlet syndrome (TOS) is a broad term used for a spectrum of syndromes related to the general region of the thoracic outlet, which involves the compression or irritation of elements of the brachial plexus, subclavian artery, or subclavian vein. Thoracic Outlet Syndrome, coriza y conjuntivitis	Diagnóstico clínico	Tratamiento sintomático
Rubéola (sarampión alemán)	Causada por el virus Virus Viruses are infectious, obligate intracellular parasites composed of a nucleic acid core surrounded by a protein capsid. Viruses can be either naked (non-enveloped) or enveloped. The classification of viruses is complex and based on many factors, including type and structure of the nucleoid and capsid, the presence of an envelope, the replication cycle, and the host range. Virology de la rubéola Finas máculas rosadas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la cara y el cuello Se vuelve puntiforme y se extiende al AL Amyloidosis tronco y a las extremidades Menos extenso que el sarampión Manchas de Forschheimer (petequias en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el paladar blando) Asociada con fiebre, linfadenopatía y conjuntivitis	Diagnóstico clínico Pruebas serológicas	Tratamiento sintomático
5ta enfermedad (eritema infeccioso)	Causado por el parvovirus B19 Parvovirus B19 Primate erythroparvovirus 1 (generally referred to as parvovirus B19, B19 virus, or sometimes erythrovirus B19) ranks among the smallest DNA viruses. Parvovirus B19 is of the family Parvoviridae and genus Erythrovirus. In immunocompetent humans, parvovirus B19 classically results in erythema infectiosum (5th disease) or “slapped cheek syndrome.” Parvovirus B19 Síntomas prodrómicos iniciales Erupción en “mejilla abofeteada” Seguida de una erupción morbiliforme en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el torso y las extremidades	Diagnóstico clínico Rara vez se necesitan pruebas de IgM IgM A class of immunoglobulin bearing mu chains (immunoglobulin mu-chains). Igm can fix complement. The name comes from its high molecular weight and originally being called a macroglobulin. Immunoglobulins: Types and Functions o PCR PCR Polymerase chain reaction (PCR) is a technique that amplifies DNA fragments exponentially for analysis. The process is highly specific, allowing for the targeting of specific genomic sequences, even with minuscule sample amounts. The PCR cycles multiple times through 3 phases: denaturation of the template DNA, annealing of a specific primer to the individual DNA strands, and synthesis/elongation of new DNA molecules. Polymerase Chain Reaction (PCR).	Tratamiento sintomático
Fiebre escarlatina	Causada por Streptococcus Streptococcus Streptococcus is one of the two medically important genera of gram-positive cocci, the other being Staphylococcus. Streptococci are identified as different species on blood agar on the basis of their hemolytic pattern and sensitivity to optochin and bacitracin. There are many pathogenic species of streptococci, including S. pyogenes, S. agalactiae, S. pneumoniae, and the viridans streptococci. Streptococcus pyogenes Comienza con fiebre y dolor Dolor Inflammation de garganta Mejillas sonrojadas Lengua de fresa Erupción en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum forma de papel de lija en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum cuello, tronco y extremidades Líneas de Pastia	Diagnóstico clínico Antígeno rápido o cultivo de garganta para confirmar	Penicilina Amoxicilina
Varicela	Causada por el virus Virus Viruses are infectious, obligate intracellular parasites composed of a nucleic acid core surrounded by a protein capsid. Viruses can be either naked (non-enveloped) or enveloped. The classification of viruses is complex and based on many factors, including type and structure of the nucleoid and capsid, the presence of an envelope, the replication cycle, and the host range. Virology de la varicela-zóster La erupción aparece en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum brotes y progresa de máculas a pápulas y a vesículas sobre una base roja Las lesiones acaban formando una costra. Prurito intenso Comienza en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el tronco y se extiende a la cara y las extremidades Pródromos de fiebre y malestar general	Diagnóstico clínico Se pueden realizar pruebas serológicas para confirmar el diagnóstico.	Tratamiento sintomático Considerar la terapia antiviral Antiviral Antivirals for Hepatitis B (aciclovir).

HHV: herpesvirus humano
PCR: reacción en cadena de la polimerasa

Painful vesicles on a hand (A) and foot (B) due to hand-foot-and-mouth disease — Vesículas dolorosas en una mano (A) y pie (B) debido a fiebre aftosa

Imagen: “Hand, foot and mouth disease: changing Indian scenario” por Rao PK, Veena K, Jagadishchandra H, Bhat SS, Shetty SR. Licencia: CC BY 3.0, editada por Lecturio.

Diffuse maculopapular rash on the chest and abdomen due to roseola infantum — Vesículas dolorosas en una mano (A) y pie (B) debido a fiebre aftosa

Imagen: “Hand, foot and mouth disease: changing Indian scenario” por Rao PK, Veena K, Jagadishchandra H, Bhat SS, Shetty SR. Licencia: CC BY 3.0, editada por Lecturio.

Comparación de las Erupciones Localizadas más Comunes

**Tabla: Resumen de las erupciones localizadas más comunes**
Entidad	Características	Diagnóstico	Tratamiento
Dermatitis Dermatitis Any inflammation of the skin. Atopic Dermatitis (Eczema) de contacto	Reacción de hipersensibilidad de tipo IV por alérgenos o irritantes Erupción maculopapular Maculopapular Dermatologic Examination o vesicular Eritema e hinchazón Supuración, descamación o formación de costras Prurito o dolor Dolor Inflammation ardiente	Diagnóstico clínico Pruebas de parches	Evitar los LOS Neisseria agentes causantes. Esteroides tópicos Antihistamínicos Emolientes
Tinea corporis Tinea corporis Dermatophytes/Tinea Infections	Causada por una infección de dermatofitos Parches o placas anulares con bordes elevados y escamosos Se extiende periféricamente Aclaramiento central Prurito	Preparación de KOH Cultivo fúngico	Antifúngicos tópicos u orales
Dermatitis Dermatitis Any inflammation of the skin. Atopic Dermatitis (Eczema) seborreica	Etiología desconocida Placas eritematosas y bien delimitadas Escamas amarillas grasientas Se encuentra en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum cuero cabelludo, cara, tronco y zonas intertriginosas	Diagnóstico clínico Biopsia para confirmar	Antifúngicos tópicos Esteroides tópicos Inhibidores de la calcineurina Agentes queratolíticos
Impétigo	Causado por Staphylococcus aureus Staphylococcus aureus Potentially pathogenic bacteria found in nasal membranes, skin, hair follicles, and perineum of warm-blooded animals. They may cause a wide range of infections and intoxications. Brain Abscess y S. pyogenes Evolución de pápulas a vesículas y a pústulas Costras de color miel Forma bullosa: bullas grandes y flácidas	Diagnóstico clínico Los LOS Neisseria cultivos rara vez son necesarios.	Casos leves a moderados: antibióticos tópicos Casos bullosos o graves: antibióticos orales
Celulitis	Infección bacteriana de la dermis Dermis A layer of vascularized connective tissue underneath the epidermis. The surface of the dermis contains innervated papillae. Embedded in or beneath the dermis are sweat glands; hair follicles; and sebaceous glands. Skin: Structure and Functions y los LOS Neisseria tejidos subcutáneos Eritema e induración Caliente al AL Amyloidosis tacto Pobremente delimitada	Diagnóstico clínico Cultivos de sangre si hay sepsis Sepsis Systemic inflammatory response syndrome with a proven or suspected infectious etiology. When sepsis is associated with organ dysfunction distant from the site of infection, it is called severe sepsis. When sepsis is accompanied by hypotension despite adequate fluid infusion, it is called septic shock. Sepsis and Septic Shock	Penicilinas Vancomicina para MRSA MRSA A strain of Staphylococcus aureus that is non-susceptible to the action of methicillin. The mechanism of resistance usually involves modification of normal or the presence of acquired penicillin binding proteins. Staphylococcus
Erisipela	Una infección bacteriana más superficial que la celulitis Afecta a la dermis Dermis A layer of vascularized connective tissue underneath the epidermis. The surface of the dermis contains innervated papillae. Embedded in or beneath the dermis are sweat glands; hair follicles; and sebaceous glands. Skin: Structure and Functions superior y a los LOS Neisseria linfáticos superficiales Eritema bien definido con demarcación elevada Dolor Dolor Inflammation y sensibilidad	Diagnóstico clínico Cultivos de sangre si hay sepsis Sepsis Systemic inflammatory response syndrome with a proven or suspected infectious etiology. When sepsis is associated with organ dysfunction distant from the site of infection, it is called severe sepsis. When sepsis is accompanied by hypotension despite adequate fluid infusion, it is called septic shock. Sepsis and Septic Shock	Penicilinas Vancomicina para MRSA MRSA A strain of Staphylococcus aureus that is non-susceptible to the action of methicillin. The mechanism of resistance usually involves modification of normal or the presence of acquired penicillin binding proteins. Staphylococcus
Fascitis necrosante	Infección bacteriana potencialmente mortal de los LOS Neisseria tejidos subcutáneos y la fascia Fascia Layers of connective tissue of variable thickness. The superficial fascia is found immediately below the skin; the deep fascia invests muscles, nerves, and other organs. Cellulitis Eritema, hinchazón y edema Edema Edema is a condition in which excess serous fluid accumulates in the body cavity or interstitial space of connective tissues. Edema is a symptom observed in several medical conditions. It can be categorized into 2 types, namely, peripheral (in the extremities) and internal (in an organ or body cavity). Edema rápidamente progresivos Dolor Dolor Inflammation severo Bullas y necrosis Necrosis The death of cells in an organ or tissue due to disease, injury or failure of the blood supply. Ischemic Cell Damage Toxicidad sistémica	Diagnóstico clínico Cultivo de sangre y tejidos Imagenología	Desbridamiento quirúrgico Antibióticos intravenosos de amplio espectro Soporte hemodinámico
Herpes zoster Herpes Zoster Varicella-zoster virus (VZV) is a linear, double-stranded DNA virus in the Herpesviridae family. Shingles (also known as herpes zoster) is more common in adults and occurs due to the reactivation of VZV. Varicella-Zoster Virus/Chickenpox	Causado por la reactivación del virus Virus Viruses are infectious, obligate intracellular parasites composed of a nucleic acid core surrounded by a protein capsid. Viruses can be either naked (non-enveloped) or enveloped. The classification of viruses is complex and based on many factors, including type and structure of the nucleoid and capsid, the presence of an envelope, the replication cycle, and the host range. Virology de la varicela-zóster Erupción vesicular de distribución dermatológica La erupción va VA Ventilation: Mechanics of Breathing precedida de dolor Dolor Inflammation. Complicado por neuralgia postherpética	Diagnóstico clínico PCR PCR Polymerase chain reaction (PCR) is a technique that amplifies DNA fragments exponentially for analysis. The process is highly specific, allowing for the targeting of specific genomic sequences, even with minuscule sample amounts. The PCR cycles multiple times through 3 phases: denaturation of the template DNA, annealing of a specific primer to the individual DNA strands, and synthesis/elongation of new DNA molecules. Polymerase Chain Reaction (PCR) Frotis o prueba de Tzanck	Se previene con una vacuna Los LOS Neisseria agentes antivirales pueden reducir la duración de los LOS Neisseria síntomas. Terapia sintomática

IV: intravenoso
SARM: S. aureus resistente a la meticilina
PCR: reacción en cadena de la polimerasa
KOH: hidróxido de potasio

A pruritic, vesicular eruption due to contact dermatitis — Una erupción pruriginosa y vesicular debida a una dermatitis de contacto
Imagen: “Neoprene Orthopaedic Supports: An Underrecognised Cause of Allergic Contact Dermatitis” por Hawkey S, Ghaffar S. Licencia: CC BY 3.0

Annular, scaling lesion of tinea corporis — Una erupción pruriginosa y vesicular debida a una dermatitis de contacto
Imagen: “Neoprene Orthopaedic Supports: An Underrecognised Cause of Allergic Contact Dermatitis” por Hawkey S, Ghaffar S. Licencia: CC BY 3.0

Referencias

Bircher, A. (2023). Exanthematous (maculopapular) drug eruption. UpToDate. Retrieved June 13, 2025, from https://www.uptodate.com/contents/exanthematous-maculopapular-drug-eruption
Armstrong, C.A. (2025). Approach to the clinical dermatologic diagnosis. In Corona, R. (Ed.), UpToDate. Retrieved June 13, 2025, from https://www.uptodate.com/contents/approach-to-the-clinical-dermatologic-diagnosis
Bickers DR, Lim HW, Margolis D, Weinstock MA, Goodman C, Faulkner E et al. (2006). The burden of skin diseases: 2004 a joint project of the American Academy of Dermatology Association and the Society for Investigative Dermatology. Journal of the American Academy of Dermatology 55:490-500.
Ely, J. and Stone, M. (2010). The Generalized Rash: Part I. Differential Diagnosis. American Family Physician. 81(6):726-734.
Ely, J. and Stone, M. (2010) The Generalized Rash: Part II. Diagnostic Approach. American Family Physician. 81(6):735-739.

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