What does a scrub typhus rash look like?

Initial lesion:

- Develops at the site of the bite 3 to 14 days after exposure.

- Characterized by a small (< 1 cm), dark red, slightly elevated lesion with a central black eschar.

- Painless and pruritic.

- Resolves spontaneously within a week.

Secondary rash:

- Develops 3 to 5 days after the initial lesion in about half of patients.

- Starts on the extremities and trunk, and spreads centrally to involve the palms and soles.

- Can also affect the face, ears, and neck.

- Characterized by small (1 to 3 mm), reddish-brown, maculopapular rash that blanches on pressure.

- Nonpruritic.

- Lasts for 2 to 7 days.

In severe cases, the rash may become hemorrhagic or may desquamate.