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 but may manifest as
Distribution may be extensive.
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 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: Options for Treatment of Superficial Fungal Infections*).
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