A rash accompanied by swollen lymph nodes usually stems from a viral infection, such as measles, chickenpox, or mononucleosis.
A rash is an inflammatory response that causes changes to your skin, such as redness, itching, blistering, or scaly or raised skin patches. Rashes can be the result of a variety of things.
Lymph nodes are part of your lymphatic system. They filter fluids in your body and return them to your circulation system for disposal. They also house infection-fighting cells.
You can’t typically feel your lymph nodes when you’re healthy, but they can become swollen and tender when your body is having an immune response.
Swollen lymph nodes usually feel soft and round, like a pea or bean beneath your skin. In some cases, they can feel hard.
It’s possible to develop a rash and swollen lymph nodes together. Learn about the potential causes of these symptoms.
Several different conditions can cause rash and swollen lymph nodes. Here are 15 possible causes.
Pharyngitis
Pharyngitis is often referred to simply as “sore throat.” It’s an inflammation of the pharynx, which is in the back of your throat.
It may be caused by a throat infection due to viruses, bacteria, or fungi, or by noninfectious agents such as allergies, smoke inhalation, dry air, or acid reflux.
Depending on the cause of irritation, your sore throat may be accompanied by swollen lymph nodes and other symptoms, such as the following:
Infectious mononucleosis
Infectious mononucleosis is usually caused by the Epstein-Barr virus (EBV). It can be spread through saliva, which is why it’s sometimes called “the kissing disease.”
It mainly occurs in high school and college students.
In addition to swollen lymph glands, the symptoms may include:
- fever
- sore throat
- headache
- fatigue
- night sweats
- body aches
The symptoms may last for up to 2 months.
Fifth disease
Fifth disease is a viral illness that usually causes a round, bright red rash on the arms, legs, and cheeks, which is why it’s also called “slapped cheek disease.”
It may also cause a lacy-patterned rash on the arms, legs, and upper body that might be more visible after a hot shower or bath.
Children are more likely than adults to experience a rash.
Additional symptoms of fifth disease may include:
Tonsillitis
Tonsillitis is a viral or bacterial infection of the tonsil’s lymph nodes. It can occur at any age, but it most often affects children from preschool age to mid-teens.
Symptoms include:
- sore throat
- difficulty swallowing
- fever
- chills
- headache
- bad breath
Swollen, tender tonsils and white or yellow spots on tonsils may also occur.
Chickenpox
Chickenpox is an infection caused by the highly contagious varicella-zoster virus (VZV). Clusters of itchy, red, fluid-filled blisters in various stages of healing develop all over the body.
The rash may be accompanied by:
- fever
- body aches
- sore throat
- loss of appetite
Chickenpox remains contagious until all blisters have crusted over.
Systemic lupus erythematosus (SLE)
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease. It has a wide variety of symptoms that affect many different body systems and organs.
One symptom of SLE is a butterfly-shaped face rash that crosses from cheek to cheek over the nose. Rashes may appear or get worse with sun exposure.
Among the other symptoms of SLE are:
- joint pain
- joint swelling
- fatigue
- headache
- hair loss
Leukemia
The term leukemia is used to describe multiple types of blood cancer that occur when white blood cells in the bone marrow grow out of control.
Leukemias are classified by the onset (chronic or acute) and cell types involved (myeloid cells and lymphocytes).
Painless, swollen lymph nodes, especially in the neck and armpits, are possible symptoms of leukemia. Red spots on the skin, called petechiae, may also appear.
Other leukemia symptoms may include:
Shingles
Shingles is a very painful rash that may burn, tingle, or itch, even if there are no blisters present. It’s caused by the same VZV that causes chickenpox.
A rash develops along the path of a nerve, with clusters of fluid-filled blisters that break easily and weep fluid. It appears in a linear stripe pattern most commonly on your torso, but it may appear on other parts of your body, including your face. Most blisters occur in clusters rather than a continuous line.
The rash may be accompanied by a low fever, chills, headache, or fatigue.
Cellulitis
This condition is considered a medical emergency. Urgent care may be required.
Cellulitis is caused by bacteria or fungi entering through a crack or cut in your skin.
It causes discolored, painful, swollen skin with or without oozing that spreads quickly. The affected skin can be hot and tender to the touch.
Symptoms such as fever, chills, and red streaking from the rash might be an indication of a serious infection that requires medical attention.
HIV infection
An HIV infection attacks and destroys immune cells, leaving the immune system unable to fight off other diseases and infections.
The symptoms of an acute HIV infection are similar to those of the flu. In addition to a rash or swollen lymph nodes, the symptoms may include:
- fever
- chills
- headache
- body aches
- fatigue
An acute HIV infection is contagious and can be spread in a number of ways:
- by sharing syringes or needles with someone living with HIV
- through contact with blood, semen, vaginal fluids, or anal secretions containing HIV
- through pregnancy or breastfeeding if the mother has HIV
An HIV infection most often occurs 2 to 4 weeks after the initial exposure to the virus.
Measles
Measles is a highly contagious infection caused by a virus in the cells that line your throat and lungs. It can be spread when someone with measles sneezes or coughs. The measles-mumps-rubella (MMR) vaccine can help prevent people from getting this serious infection.
A red rash spreads from your face down the body 3 to 5 days after the first symptoms of measles appear. Tiny red spots with blue-white centers may appear inside your mouth.
Other measles symptoms may include:
Rubella
The viral infection rubella is also known as German measles. It can be prevented by receiving the MMR vaccine.
A pink or red rash begins on the your and then spreads downward to the rest of your body.
Swollen and tender lymph nodes may be another symptom of rubella. Other symptoms may include:
- mild fever
- runny or stuffy nose
- headache
- muscle pain
- inflamed or red eyes
Rubella is a serious condition in pregnant people because it may cause congenital rubella syndrome in the fetus.
Scarlet fever
Scarlet fever is an infection that occurs at the same time as or right after a strep throat infection, since it’s caused by the same bacteria. It mostly affects children.
A red skin rash spreads all over the body, except for the hands and feet. The rash is made up of tiny bumps that make it feel like sandpaper.
The tongue may also be bright red and swollen, which is a condition known as strawberry tongue.
Lyme disease
Lyme disease is caused by an infection with the spiral-shaped bacteria Borrelia burgdorferi. The bacteria is transmitted through the bite of an infected black-legged deer tick.
Its signature rash is a flat, red, bull’s-eye, with a central spot surrounded by a clear circle with a wide red circle on the outside.
Lyme disease’s wide range of symptoms mimics those of many other ailments, making it difficult to diagnose.
Some of its cyclical, waxing and waning flu-like symptoms may include:
- fatigue
- fever
- chills
- body aches
- headaches
- joint pain
- night sweats
West Nile virus
West Nile virus is transmitted through the bites of infected mosquitoes.
This infection causes a wide range of symptoms, from mild, flu-like illness to meningitis and encephalitis.
Swollen nymph nodes or a rash on your back, chest, and arms are among the possible symptoms of West Nile virus. Other symptoms may include:
- fever
- headache
- body aches
- back pain
- nausea
- vomiting
- loss of appetite
- sore throat
Severe symptoms include:
- confusion
- numbness
- paralysis
- severe headache
- tremors
- balance problems
A rash and swollen lymph nodes are symptoms of an infection or immune response. If you have a minor infection, your symptoms will likely resolve on their own with time and rest. If your rash and swollen lymph nodes are caused by a serious infection, you may need medical treatment.
Enlargement of the lymph nodes, or
Certain medications can cause a syndrome called serum sickness that manifests as fever, joint pain, rash, and lymphadenopathy. Those medications include penicillin, allopurinol (Zyloprim, Lopurin), and hydralazine.
Some potential infectious and autoimmune causes of rash and swollen lymph nodes include:
- fifth disease, a viral illness marked by a red rash on your face and other parts of your body
- pharyngitis, an infection of the pharynx, often referred to simply as “sore throat”
- infectious mononucleosis, a group of symptoms caused by the Epstein-Barr virus spread through saliva, which is why some refer to it as “the kissing disease”
- tonsillitis, or infection of the tonsils, which can occur at any age but is most often found in children from preschool age to mid-teens
- measles, a viral infection that causes large, flat blotches to develop on your skin
- rubella, also known as “German measles,” a viral infection characterized by a rash that begins on your face and spreads down your body
- scarlet fever, a reaction to a strep throat infection that causes a rash to develop on your neck and chest
- chickenpox, an infection caused by a highly contagious virus that results in a blister-like rash
- systemic lupus erythematosus, a chronic condition that can cause a butterfly-like rash to develop over your cheeks and the bridge of your nose
- shingles, a painful rash caused by the same virus that causes chickenpox
- Lyme disease, a bacterial infection spread by ticks that leaves a solid oval or “bull’s eye” rash
- West Nile virus, a serious viral infection spread by mosquitoes
- acute HIV infection, the initial stage of HIV, which isn’t always detectable by standard HIV antibody tests
- leukemia, a cancer of the blood cells
- skin infections, such as cellulitis
Call 911 or local emergency services immediately if your rash and swollen lymph nodes are accompanied by breathing difficulties, tightness in your throat, or swelling in your face.
Make an appointment with a doctor if:
- you experience fever or joint pain along with your rash and swollen lymph nodes
- your lymph nodes feel hard and rock-like
- you experience swelling on or near your rash
- your symptoms don’t improve in 2 days
This information is a summary. Always seek medical attention if you’re concerned that you may be experiencing a medical emergency.
To treat your rash and swollen lymph nodes, a doctor will try to diagnose and address the underlying cause of your symptoms. They’ll likely start by studying your symptoms and medical history.
A doctor will ask you several questions, such as:
- When did your symptoms begin?
- Does anything cause your symptoms to get worse or better?
- Have you recently been exposed to anyone who’s sick?
Rash and swollen lymph nodes tend to stem from viral infections. Antibiotics are ineffective for treating this type of infection. A doctor may recommend other medications to help relieve your symptoms.
For example, a doctor may encourage you to apply an anti-itch cream or take an antihistamine to reduce the itchiness or pain caused by your rash.
It’s important to follow a doctor’s recommended treatment plan. In many cases, rest is the best healer for viral infections that cause rash and swollen lymph nodes.
You can also take the following steps at home to achieve greater comfort:
- Keep the rash-covered portions of your skin clean and dry to help reduce irritation.
- Wash your skin with mild, unscented soap and warm water. Gently pat it dry.
- Avoid rubbing or scratching your rash, which can irritate it more.
- Rest and avoid overexertion to give your body the chance to heal.
- Drink cool, clear fluids to maintain hydration.
- Taking over-the-counter (OTC) anti-inflammatory medications, such as ibuprofen (Advil), can also help relieve pain associated with your illness.
Washing your hands regularly with warm water and soap helps prevent infections. Use an alcohol-based hand sanitizer to help kill infection-causing germs when soap and water aren’t available.
Try to avoid exposure to people with known infections.
You should also keep your vaccinations up to date.