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.
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.
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:
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:
Causes with accompanying symptoms
Health issues that can cause a non-blanching rash with other symptoms include:
There are many types of vasculitis that affect people in different ways. However, some common symptoms include:
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 (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.
- red or purple non-blanching rash on the buttocks, legs, and feet
- sore, swollen joints
- stomach pain
- 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 (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:
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 symptoms include:
- non-blanching rash
- stiff neck
- sensitivity to light
Meningitis is a very serious medical condition. If a person is experiencing the above symptoms, they should seek emergency medical attention.
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
- loss of consciousness
Sepsis can be life threatening, and a person experiencing this condition requires urgent medical attention.
Many of the causes for non-blanching rashes in adults also affect children, including:
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.
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.
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
- feeding poorly
In serious cases, the baby might have seizures.
Infants under 12 months of age are also more likely to develop sepsis than other age groups.
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.
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.
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.
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.
If bleeding is severe, doctors might prescribe steroids. However, not everyone with ITP needs treatment.
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.
Standard treatment includes antibiotics. Doctors will keep a close eye on the individual to make sure all their organs are getting enough healthy blood.
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.