A 20 month old girl is brought to the Emergency Department with a rash. She has had a one month history of upper respiratory symptoms, and has just completed a ten day course of Cefdinir of sinusitis. Two days prior to admission (day 10 of cefdinir), a light rash erupted on her chest. She was given Benadryl, and one dose of prednisolone by her primary care physician one day prior to admission. The rash continued to worsen, and was very pruitic. Her parents tell you that she stopped walking now due to the swelling in her feet. Itching and swelling improved with oral antihistamines, and the next day she was walking and playing. The eruption cleared completely within a week. Urticaria multiforme is a variant of urticaria in which urticaria and angioedema are present, the lesions are itchy, the lesions are not fixed, and the symptoms and lesions improve with oral antihistamines.
symmetric generalized discrete and confluent annular plaques with targetoid borders and dusky centers associated with angioedema