Scrub Typhus Rash: Symptoms, Appearance & What to Expect

Initial Lesion (Eschar)

• Develops at bite site 3–14 days post-exposure.
• Small (<1 cm), dark red, slightly elevated with central black eschar.
• Painless and pruritic (itchy).
• Resolves spontaneously within a week.

Secondary Rash

• Appears 3–5 days after initial lesion in ~50% of patients.
• Starts on extremities/trunk, spreads centrally to palms/soles; may affect face, ears, neck.
• Small (1–3 mm), reddish-brown, maculopapular, blanches on pressure.
• Non-pruritic.
• Lasts 2–7 days.

Severe cases: Rash may become hemorrhagic or desquamate (peel).