Which physical findings are characteristic of id reaction (autoeczematization)?

Updated: Oct 16, 2020
  • Author: Matthew P Evans, MD; Chief Editor: Dirk M Elston, MD  more...
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Clinical lesions of id reactions are quite variable and are largely predicated on the inciting etiology. Lesions are, by definition, at a site distant from the primary infection or dermatitis. They are usually distributed symmetrically. Clinical forms include the following:

  • A widespread, symmetrical eruption of small follicular papules associated with a kerion and a pompholyxlike eruption are usually associated with inflammatory tinea pedis (common). [20]

  • An acute, intensely pruritic, symmetric maculopapular or papulovesicular reaction that involves the forearms, thighs, legs, trunk, face, hands, neck, and feet (in descending order of frequency) is typical of the id reaction with stasis dermatitis (common).

  • Erysipelaslike eruption on the anterior leg secondary to a dermatophytosis may occur (less common).

  • Extracutaneous manifestations include fever, anorexia, generalized adenopathy, splenomegaly, and leukocytosis (uncommon).

  • The clinical picture may rarely mimic erythema multiforme. [21]

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