Cinco casos de urticaria multiforme y revisión de la literatura

Abstract

Urticaria multiforme is a cutaneous disorder that affects infants and small children. It is characterized by large, annular urticarial plaques with a violaceous center and is frequently accompanied by fever. Urticaria multiforme follows a benign, self-limiting course, but the striking appearance of the lesions can cause alarm and considerable anxiety among parents. We present 5 cases of urticaria multiforme seen in our hospital over a period of 18 months. All the cases were preceded by an infection of the upper airways or otitis, and they were all empirically with amoxicillin. It is important to be familiar with this condition to reassure parents and avoid unnecessary hospital admissions and tests.

A circinate rash in a child

“…Urticaria multiforme (UM) may be distinguished by the transient nature of the lesions and lack of significant systemic symptoms . Individual lesions typically resolve within 24 hours, with full resolution of the appearance of urticarial plaques within 10 days without residua . The presence of dermatographism and acral edema also supports a diagnosis of UM …”

“…Urticaria multiforme has been reported in association with both viral and bacterial upper respiratory infection, otitis media, pharyngitis, gastroenteritis, vaccinations, and medications including furazolidone or amoxicillin . It is a clinical diagnosis made based on its distinct appearance and accompanying acral and facial edema and dermatographism .…”

Urticaria multiforme: a case report in an infant

“…Urticaria multiforme (UM) is an uncommon benign cutaneous hypersensitivity that occurs mainly in pediatric patients 1, 2. It is characterized by annular lesions with a violaceous center, and may be accompanied by short-term fever, as well as by hand and foot edema 2, 3. It is a poorly recognized condition, mainly due to lack of reports in the literature.…”

“…In most cases there is a temporal relationship with infections (mycoplasma, adenovirus, streptococci, Epstein–Barr), medications (mainly antibiotics), and vaccinations. In 2016, Sempau et al found an association with previous use of amoxicillin 3 . Specifically in neonates, there has been proven infection by herpes virus 6, and decreased viral load accompanied by clinical improvement of the patient 4…”

“…The diagnostic criteria are: annular, transitory, ecchymotic-center plaques, each lesion lasting less than 24 h, associated fever episode, total duration of the condition being less than ten days, and edema of the extremities 3 . Laboratory tests are not necessary, a good anamnesis and a dermatological physical examination are sufficient.…”