Could something other than drug sensitivity explain this rash?

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Authors: 

AMY RIEF-ELKS, DO
and MOHAMMAD R. MOHEBBI, MD
Siouxland Medical Education Foundation, University of Iowa

Dr Rief-Elks is a faculty physician and Dr Mohebbi is a family medicine resident at the Siouxland Medical Education Foundation, University of Iowa in Sioux City.

KIRK BARBER, MD, FRCPC––Series Editor: Dr Barber is a consultant dermatologist at Alberta Children’s Hospital and clinical associate professor of medicine and community health sciences at the University of Calgary in Alberta.

Case: A 4 1/2-year-old girl is brought for evaluation of a generalized, pruritic, erythematous rash. The rash first appeared on the face and upper trunk and then spread to the upper and lower extremities over the next 12 hours.

The child was afebrile and had no respiratory symptoms. Five days earlier, she had started taking cephalexin for a sore throat. She had a history of an allergic reaction to amoxicillin, which consisted of an erythematous rash and pruritus that resolved after the antibiotic was discontinued.

Could something other than drug sensitivity explain this rash?

(Answer on next page.)

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