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Dermatophytid Reaction

By Denise M. Aaron, MD

A dermatophytid reaction is the body's reaction to a dermatophyte (fungal) infection and is a skin eruption that appears on an area of the body that is not the area where the infection first began.

A fungal infection on one area of the body (see page Overview of Dermatophytoses (Ringworm, Tinea)) can cause a skin eruption to appear on another area of the body that is not infected. For example, a fungal infection on the foot may cause an itchy, bumpy rash to appear on the fingers. These eruptions (dermatophytids, or identity or id reactions) are allergic reactions to the fungus. They do not result from touching the infected area. The eruptions may appear on many different areas of the body at once.

The eruptions are typically itchy. They may take various forms, for example, small, fluid-filled spots (on the hands or feet); solid bumps; red, raised patches; deep, raised, bruiselike areas on the shins; pinkish red spots that resemble targets; or hives.

Doctors base the diagnosis on an examination of skin scrapings. Scrapings taken from the areas that have the dermatophyte infection show the fungus, but scrapings taken from the areas that have the dermatophytid reaction do not. This combination of findings indicates that the second (separate) eruption is a dermatophytid reaction.

The dermatophytid reaction goes away once the dermatophyte infection has been cured. To relieve symptoms, doctors give corticosteroid creams, anti-itch drugs taken by mouth (such as hydroxyzine), or both.

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