Dermatology disorders

Why does this eruption resolve and recur?

David L. Kaplan, Md––Series Editor: Dr Kaplan is clinical assistant professor of dermatology at the University of Missouri Kansas City School of Medicine and at the University of Kansas School of Medicine. He practices adult and pediatric dermatology in Overland Park, Kan.



A 42-year-old woman presents with an acute pruritic eruption that began 2 days earlier on her face, trunk, and extremities. The lesions resolve and recur at different sites from one day to the next. The outbreak began after the patient ate Chinese food the night before; she also had a recent sinus infection. She takes vitamin supplements.

Can you identify this eruption?

A. Urticaria.

B. Adverse drug reaction.

C. Psoriasis.

D. Pityriasis rosea.

E. Granuloma annulare.

(Answer on next page)

Pruritic wheals that arise in one location, resolve, and then erupt elsewhere within 48 hours are a classic presentation of urticaria, A. Both sinusitis and spicy foods have been implicated as causes. Over-the-counter products such as vitamins are less commonly associated with urticaria.

Psoriasis and pityriasis rosea can flare after an upper respiratory tract infection; however, these conditions feature scaling. Granuloma annulare is fixed and asymptomatic.