Summary
Differentials
Common
- Allergy to food or drug
- Insect bites or stings
- Adverse drug reaction (e.g., to antibiotic, anticonvulsant, or allopurinol)
- Chemotherapy
- Enterovirus and echovirus infection
- Fifth disease (erythema infectiosum)
- Roseola infantum (sixth disease)
- Epstein Barr virus (EBV) infection (infectious mononucleosis)
- Cytomegalovirus (CMV) infection
Uncommon
- Iodinated contrast media nonimmediate adverse reaction
- Toxic epidermal necrolysis/Stevens-Johnson syndrome
- Drug reaction with eosinophilia and systemic symptoms
- Erythema multiforme
- HIV-seroconversion exanthema (also known as acute retroviral syndrome)
- Mpox
- Sepsis
- Acute hepatitis B virus infection
- Acute hepatitis C virus infection
- Rubella (German measles)
- Rubeola (measles)
- Meningococcemia
- Scarlet fever
- Staphylococcal scalded skin syndrome
- Toxic shock syndrome (Staphylococcus exotoxin)
- Rocky Mountain spotted fever or Mediterranean spotted fever
- Acute graft-versus-host disease
- Kawasaki disease (mucocutaneous lymph node syndrome)
- Juvenile-onset or adult-onset Still disease
- Syphilis (secondary)
- Ebola virus infection
- Zika virus infection
- Chikungunya virus infection
- Dengue fever
Contributors
Authors
Adelaide A. Hebert, MD
Professor & Director of Pediatric Dermatology
Department of Dermatology and Pediatrics
UTHealth McGovern Medical School Houston
Houston
TX
Disclosures
AAH has received research grants paid to UTHealth McGovern Medical School Houston from Pfizer, GlaxoSmithKline (GSK), Novan, Dermavant, Arcutis, and Verrica; has received honoraria from Pfizer, Verrica, and Novan; and is on data safety monitoring boards for GSK, Ortho Dermatologics, and Regeneron-Sanofi.
Yamila Goenaga, MD
Dermatology Resident
Department of Dermatology
University of Texas Health Sciences Center in Houston
Houston
TX
Disclosures
YG declares that she has no competing interests.
Alexander J. Jafari, MD, MPH
Clinical Research Fellow
Department of Dermatology
UTHealth McGovern Medical School Houston
Houston
TX
Disclosures
AJJ declares that he has no competing interests.
Acknowledgements
Dr Adelaide A. Hebert, Dr Yamila Goenaga, and Dr. Alexander Jafari would like to gratefully acknowledge Dr Quoc-Bao Nguyen, Dr Mary DarConte, Dr Mark Naftanel, and Dr Hobart W. Walling, previous contributors to this topic.
Disclosures
QN, MD, MN, and HWW declare that they have no competing interests.
Peer reviewers
Brian Swick, MD
Clinical Assistant Professor
University of Iowa College of Medicine
Iowa City
IA
Disclosures
BS declares that he has no competing interests.
Kimberly Schulz, MD
Dermatologist
Town Square Dermatology
Coralville
IA
Disclosures
KS declares that she has no competing interests.
References
Key articles
Resuscitation Council UK. Emergency treatment of anaphylactic reactions: guidelines for healthcare providers. May 2021 [internet publication].Full text
Joint Task Force on Practice Parameters; American Academy of Allergy, Asthma and Immunology; American College of Allergy, Asthma and Immunology, et al. Drug allergy: an updated practice parameter. Ann Allergy Asthma Immunol. 2010 Oct;105(4):259-73. Abstract
McCrindle BW, Rowley AH, Newburger JW, et al. Diagnosis, treatment, and long-term management of Kawasaki disease: a scientific statement for health professionals from the American Heart Association. Circulation. 2017 Apr 25;135(17):e927-99.Full text Abstract
Khan DA, Banerji A, Blumenthal KG, et al. Drug allergy: a 2022 practice parameter update. J Allergy Clin Immunol. 2022 Dec;150(6):1333-93.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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