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DR MOHAMMED IRFAN SHEIKH
DR MOHAMMED IRFAN SHEIKH almost 6 years ago
Urticaria Multiforme

Urticaria Multiforme

A 3-year-old girl presented to the emergency department on day 1 of a mild pruritic urticarial rash. There was no history of exposure to medications or allergens and no history of similar symptoms. The parents described a viral respiratory illness that had occurred 1 week earlier. Fever (38.8°C) developed on day 2, when the child was at home, as did a generalized polycyclic annular rash with wheals and ecchymotic centers (Panel A). On day 3, the child returned to the emergency department with a persistent low-grade fever and swelling of the hands, feet, and face. Physical examination was notable for acral edema and a blanching arcuate urticarial rash (Panels B and C, respectively). Dermographism was elicited by pressure from a pen (Panel D). There was no mucosal involvement. Complete blood count, urinalysis, and serum chemical analysis were unremarkable. A diagnosis of urticaria multiforme was made, and the child was treated with diphenhydramine. The rash resolved on day 6 with no further sequelae. Because of the annular nature of the rash, a frequently antecedent infection, and its often dramatic presentation, the condition is commonly misdiagnosed as erythema multiforme or other more serious cutaneous conditions.

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Top rated comment
almost 6 years ago

Thanks

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almost 6 years ago

Cool

almost 6 years ago

Makes me think of fifth disease as well. Anyhow, interesting case, thanks !

almost 6 years ago

An intersying case.thank you for presenting

almost 6 years ago

Adding cimetidine could have resolved it a little faster.

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