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ID Reaction

Sahil Mullick, MD Reviewed 06/2019
 


BASICS

DESCRIPTION

A generalized skin reaction associated with various infectious (fungal, bacterial, viral, or parasitic) or inflammatory cutaneous conditions distant from the primary disease site (1)...

DIAGNOSIS

HISTORY

Itchy rash: Inquire about presence of lesions (typically fungal or bacterial) that could have incited the id reaction in the preceding days to weeks. 

PHYSICAL EXAM

  • Common

    • Symmetric, pru...

TREATMENT

GENERAL MEASURES

  • Outpatient treatment of the underlying infection or eczematous dermatitis

  • Symptomatic treatment of pruritus with antihistamines and/or topical steroids if needed (may require ...

ONGOING CARE

PATIENT EDUCATION

Avoid hot, humid conditions that promote fungal growth. Aerate susceptible body areas (e.g., wear sandals or open footwear). If possible, wear loose-fitting clothing and ...

REFERENCES

1
Ilkit M, Durdu M, Karakaş M. Cutaneous id reactions: a comprehensive review of clinical manifestations, epidemiology, etiology, and management. Crit Rev Microbiol.  2012;38(3):191–202...

ADDITIONAL READING

  • Elmariah SB, Lerner EA. Topical therapies for pruritus. Semin Cutan Med Surg.  2011;30(2):118–126. [View Abstract on OvidMedline]

  • Paulsen LL, Geller DD, Guggenbiller M. Symmetri...

CODES

ICD10

  • L30.2 Cutaneous autosensitization

  • B35.9 Dermatophytosis, unspecified

ICD9

  • 692.89 Contact dermatitis and other eczema due to other specified agents

  • 110.9 Dermatophytosis of unspecified site

SNOMED

CLINICAL PEARLS

  • When one skin eruption follows another closely in time, consider an id reaction.

  • When assessing an itchy rash, inquire about potential fungal or bacterial lesions in the preceding days ...

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