Dermatophytid reaction is an inflammatory reaction to dermatophytosis at a cutaneous site distant from the primary infection. Diagnosis is by potassium hydroxide wet mount. Treatment depends on the primary dermatophytosis.
Dermatophytid (identity or id) reactions are protean; they are not related to localized growth of the fungus but rather are an inflammatory reaction to a dermatophytosis elsewhere on the body.
Lesions are typically pruritic and may manifest as
Vesicular eruptions on the hands and feet
Follicular papules
Erysipelas-like plaques
Erythema annulare centrifugum
Distribution may be extensive.
Diagnosis of Dermatophytid Reaction
Potassium hydroxide wet mount
Diagnosis of dermatophytid reaction is by potassium hydroxide wet mounts that are negative at the site of the id reaction and positive at the distant site of dermatophyte infection.
Treatment of Dermatophytid Reaction
Treatment of the primary dermatophytosis
Treatment of the primary infection cures dermatophytid; pending cure, topical corticosteroids and/or antipruritics (eg, hydroxyzine 25 mg orally 4 times a day) can be used to relieve symptoms (see table Treatment of the primary infection cures dermatophytid; pending cure, topical corticosteroids and/or antipruritics (eg, hydroxyzine 25 mg orally 4 times a day) can be used to relieve symptoms (see tableOptions for Treatment of Superficial Fungal Infections).
