Hypersensitivity (allergic) reaction to a new multivitamin.
I use the term hypersensitivity reaction here to be the same as a drug eruption, but I separate it out to illustrate that non-drugs can be very common.
- Supplements, vitamins, lotions etc. can all cause allergic reactions.
A diffuse maculopapular eruption is seen. It should be symmetric. Make sure no burrows as in scabies. Ask about new vitamins, supplements, topical exposures e.g. body lotions. If present for less than a week, a viral exanthem can appear similarly.
Things I have found in past
- Cinnamon pills
- New body lotion
- New prescription drug
- Herb supplement
A skin biopsy may show a perivascular infiltrate with eosinophils.
The offending drug should be stopped immediately. Prednisone may be given if the reaction is severe.
This patient experienced the acute onset of diffuse itchy red papules symmetric on the body (here on the leg). The cause? A new herb supplement.
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