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October 1989

Wheals and Erythematous Papules in a Generalized Distribution

Author Affiliations

The Cleveland (Ohio) Clinic Foundation

Arch Dermatol. 1989;125(10):1415-1416. doi:10.1001/archderm.1989.01670220111019

REPORT OF A CASE  A 15-year-old girl presented to the Department of Dermatology complaining of a generalized, suddenonset, pruritic, cutaneous eruption following intermittent nausea and vomitting for 5 days. Her medical history was significant for infrequent recurrent transient attacks of the same generalized pruritic eruption since age 2 weeks. The patient stated that she had been treated in the past with cyproheptadine, diphenhydramine, and hydroxyzine. She had recently had streptococcal pharyngitis and infectious mononucleosis, which preceded the onset of the cutaneous eruption. She also admitted to missing her two previous menstrual periods. She was receiving no medications and denied any history of drug abuse.Physical examination disclosed wheals and erythematous papules in a generalized distribution. Firm stroking of the skin produced new wheals (Fig 1).A skin biopsy specimen was taken from the right foramen. The result of the biopsy is illustrated in Figs 2 and 3.What is your

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