ID Reaction

Sahil Mullick, FAAFP, MD and Diana V Steau, MD Reviewed 05/2023

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

Ilkit M, Durdu M, Karakaş M. Cutaneous id reactions: a comprehensive review of clinical manifestations, epidemiology, etiology, and management. Crit Rev Microbio...

ADDITIONAL READING

Atibacterials/terbinafine: Id reaction in the form of erythema nodosum, tarsal arthritis and abdominal pain: Case report. Reactions Weekly. 2020;1785(1):49. doi: 10.1007/...

CODES

ICD10

L30.2 Cutaneous autosensitization
B35.9 Dermatophytosis, unspecified

SNOMED

3014005 Id reaction
30668009 allergy-sensitivity to fungi syndrome (disorder)

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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