Pruritic rash associated with cat scratch disease

Cat scratch disease is a benign, self-limited illness characterized by regional lymphadenopathy that usually occurs in association with a history of contact with a cat. Cases of cat scratch disease with skin manifestations that included erythema nodosum; erythema multiforme; erythema marginatum; and non-specific maculopapular, petechial, and morbilliform rashes have been reported. No case of pruritic rash associated with cat scratch disease has been previously reported. In fact, one authority specifically states that the rash of cat scratch disease is nonpruritic. We report a well-documented case of cat scratch disease in which the patient's principal symptom was a pruritic rash. It is possible that this rash was the result of an immunologic reaction to the infectious agent of cat scratch disease. We conclude that cat scratch disease should be included in the differential diagnosis of pruritic rashes in children.