A very frightening but not dangerous rash in children

We present a patient with Urticaria Multiforme (UM). This is not a very frequent disease in primary care.

Their general condition is usually excellent, with no systemic symptoms, although some short-term fever might be present. There is also oedema, usually affecting the face, lips, and extremities. No cases of airway angioedema had been reported in UM. Pruritus is a common symptom. Dermographism is usually present. Laboratory tests are not needed to diagnose UM. UM can be diagnosed safely and accurately based on a thorough clinical history and physical examination.

Systemic antihistamines are the cornerstone of treatment, providing relief from pruritus. In refractory and severe cases, the use of systemic corticosteroids may be necessary.

GPs should be aware of this entity because the general condition of the child is very good and lesions are almost pathognomonic. This will avoid the child to undergo for unnecessary laboratory evaluation and hospital referral.