title: Urticarial eruption associated with rheumatic fever in a child.
abstract: The classic description of erythema marginatum is of a few asymptomatic erythematous patches or plaques with a characteristic central clearing which may coalesce and develop a polycyclic configuration. We report a boy with a urticarial eruption without the classic lesions of erythema marginatum in whom the diagnosis of rheumatic fever was subsequently made. Histology of the urticarial lesions revealed a mixed, superficial, perivascular infiltrate with prominent eosinophils. Rheumatic fever should be considered in children with fever and urticaria-like eruptions even in the absence of the classically described erythema marginatum.
authors.affiliation: Department of Dermatology, Johns Hopkins Medical Institutions, Baltimore, Maryland 21205, USA. hnousari@welchlink.welch.jhu.edu
authors.forename: H C
authors.initials: HC
authors.lastname: Nousari
authors.forename: A
authors.initials: A
authors.lastname: Kimyai-Asadi
authors.forename: N
authors.initials: N
authors.lastname: Ketabchi
authors.forename: B A
authors.initials: BA
authors.lastname: Cohen
mesh_terms: D000293:Adolescent; D004890:Erythema / Q000209:etiology*; D006327:Heart Block / Q000150:complications / Q000188:drug therapy; D006801:Humans; D008297:Male; D008944:Mitral Valve Insufficiency / Q000150:complications / Q000188:drug therapy; D012214:Rheumatic Heart Disease / Q000150:complications* / Q000188:drug therapy; D013297:Streptococcus pyogenes / Q000302:isolation & purification