Autosensitization dermatitis: A case of rosacea-like id reaction

Abstract

Autosensitization dermatitis, or id reaction, is a cutaneous phenomenon in which an acute secondary dermatitis develops at a location distant from a primary inflammatory focus. The most commonly reported autosensitization dermatitis occurs in patients with venous stasis, with an estimated 37% of these patients experiencing 1 or more episodes of a dermatitis distant to the legs.1 Autosensitization also frequently results from cases of infection. The classic example of an infectious etiology resulting in autosensitization is tinea pedis causing an eczematous eruption on the hands and/or legs. However, multiple infectious organisms including bacteria, viruses, parasites, and fungi are found to cause reactions at areas distant to the site of infection. Id reactions do not always present as eczematous eruptions and may be urticarial, lichenoid, morbilliform, psoriatic, or scarlatiniform in morphology. Additionally, erythema nodosum and erythema multiforme have been observed, among other cutaneous responses.2 Here we report a case of a 46-year-old woman with a history of periodontal disease who presents with erythematous papules and pustules on the face, initially diagnosed as papulopustular rosacea but resistant to all usual treatments for this disease. Later, she was found to have a rosacea-like id reaction in response to an oral infection after treatment with amoxicillin-clavulanate.