Introduction: Rickettsiosis are emerging, life-threatening infectious diseases that are world-wide distributed and have various manifestations. Most of the time, skin involvement is the prominent feature of clinical manifestations. Clinicians must therefore be well aware of these various clinical pictures.
Current knowledge and key points: Knowledge about rickettsial infections has recently improved due to either the identification of new vectors and reservoirs, the description of new systemic and cutaneous signs and symptoms, or the amelioration of diagnosis methods. Cutaneous manifestations mainly depend on the type of microorganism and on the host characteristics. In some cases, they are so typical that their only identification would lead to the diagnosis.
Future prospects and projects: As growing population movements may lead to an increase in the disease incidence, detailed knowledge of clinical, particularly cutaneous, manifestations of rickettsiosis is required in order to improve both diagnosis and treatment. When identified, cutaneous manifestations of rickettsiosis allow the clinician to confirm rapidly the diagnosis, using polymerase chain reaction or immunofluorescence and to institute prompt and specific treatment, thus reducing unfavorable disease outcome.