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Ang

Red pin prick spots

I have red pin prick spots all over my back, tummy and torso. I feel achey, flu-like symptoms and am very tired.

26 April 2021

Thank you for getting in tough with AXA Health at Hand team, I am sorry to hear that you have been feeling unwell recently.

When we are looking at diagnosing rashes there are lots of factors to take into account, including whether the spots raised or itchy, do they disappear under pressure, have you recently had a change in any products used, food eaten or medications, as well as how you are feeling within yourself. I am not sure how long you have been feeling unwell and have had this rash but, because of all these additional factors, the best thing to do will be to get in touch with your GP for an assessment and diagnosis. There are many potential causes of a rash that appears as red pin pricks; some of which could signify a more serious condition that requires prompt medical attention; I will discuss further some possible causes below:

Potentially serious causes

Whilst they may appear as a 'rash', sometimes these red pin prick spots can actually be due to bleeding under the skin when our tiny capillaries burst; this is known as petechiae (Healthline, 2021). One way to tell whether the spots are a rash or petechiae is to see whether they disappear (turn white) under pressure, for example by using the 'glass test'; petechiae will also likely not be raised and will feel flat to the skin (Mayo clinic, 2021).

The glass test

To perform the glass test you, or someone else, should run an empty clear glass over the rash. If the spots disappear (turn white) under the pressure then this is glass test negative; if the spots can still be seen through the glass then this may be seen as a glass test positive result (Meningitis Now, 2021). Please note that the spots may be harder to see on dark skin and you may need to check in areas such as the palms of the hands, soles of the feet or roof of the mouth (NHS, 2021).

If these spots are 'glass test positive' then it is really important to seek an urgent medical assessment as this could potentially be a sign of life-threatening condition such as sepsis or meningitis (NHS, 2021).

This is especially important if along with the red spots you are experiencing a stiff neck, severe headache, light sensitivity, high fever or feeling very unwell; if you have these additional symptoms you should attend your local A&E for an urgent assessment.

Some other potential causes

While it's important to seek a review to rule out potentially serious conditions, especially if accompanied by additional symptoms, there are also other, less serious causes of the appearance of these pin prick spots along with feeling unwell. I will discuss a few of these possible causes below: 

Skin trauma

We can sometimes notice the appearance of these pin prick red spots after trauma to our skin, such as through excessive scratching, rubbing, pressure or from straining (for example through heavy lifting or coughing) (Healthline, 2021); however if this was the cause it is unlikely that you would also be feeling unwell and the 'rash' is likely to be more localised rather than widespread.

Medication

Certain medications may cause this skin reaction. If you have recently changed any of your medications, altered a dose or commenced on any new medications then it would be sensible to speak to your GP regarding this potential skin reaction (Healthline, 2021).

Viral infections

Many viral infections can cause a rash along with additional symptoms, which will vary depending on the type of virus in question (Patient UK, 2021). Some rashes have a 'characteristic' appearance, such as chicken pox or measles, which may help your GP to determine what virus is the likely cause of this, however many times a viral rash will be non-specific and will usually disappear on its own within a few day; a viral rash will be 'glass test negative' (Patient UK, 2021).

Next steps 

While this gives a limited number of examples of potential causes, it is certainly not an exhaustive list and, as above, in order to get a firm diagnosis and rule out any potentially serious causes it would be vital for you to visit your GP for a review. If the rash is 'glass test positive', you feel extremely unwell, have a severe headache or light sensitivity along with this rash it is important that you seek a more urgent medical assessment; for example at your local accident and emergency department or by calling the NHS 111 service. While you are recovering, make sure that you drink plenty of water to reduce the likelihood of dehydration (which you are more at risk of if you have a virus with fever) and you may want to take over the counter painkillers such as paracetamol to help with the muscle aches.

I do hope you start to feel better soon, if you would like to discuss anything through further you can contact one of the nurses in the Health at Hand team on 0800 003 004; we are available 24/7.

Answered by the Health at Hand team.

References

Healthline, 2021. What causes petechiae?. Available at: Petechiae: Causes, Treatments, Pictures, and More (healthline.com). (Accessed 26 April 2021).

Mayo clinic, 2021. Petechiae. Available at: Petechiae - Mayo Clinic. (Accessed 26 April 2021).

Meningitis Now, 2021. Meningitis glass test. Available at: Meningitis Glass Test - Meningitis Rash Test | Meningitis Now. (Accessed 26 April 2021).

NHS, 2021. Meningitis - symptoms. Available at: Meningitis - Symptoms - NHS (www.nhs.uk). (Accessed 26 April 2021).

Patient UK, 2021. Viral rashes. Available at: Viral Rashes. Rashes and Itchy Skin. Causes and treatment | Patient. (Accessed 26 April 2021).

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