Dermatophytid Reaction

(Identity Reaction or Id Reaction)

ByDenise M. Aaron, MD, Dartmouth Geisel School of Medicine
Reviewed/Revised Sep 2023
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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.

(See also Overview of Fungal Skin Infections.)

A dermatophytid reaction is not actually a type of dermatophytosis. Rather, a fungal infection on one area of the body can cause an allergic 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, also called 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 appear as

  • 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

  • Red, raised swellings (hives)

Diagnosis of Dermatophytid Reaction

  • Examination of skin scrapings

Doctors base the diagnosis of dermatophytid reactions 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.

Treatment of Dermatophytid Reaction

  • Treatment of the first infection

The dermatophytid reaction goes away once the dermatophyte infection has been cured on the area of the body where the infection is.

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