Time After Time: A Second Look at Evolving Rash With Multiple Exposures to Amoxicillin

Pediatric penicillin drug reactions may present in many forms such as erythema multiforme, serum-sickness, serum-sickness-like reaction (SSLR), Henoch-Schonlein Purpura (HSP), and urticarial vasculitis. Here, we review the case of a 13-month-old with atypical presentation of a drug reaction with increasing severity after each exposure to amoxicillin. We discuss the various differential diagnoses in comparison to our patient’s presentation and conclude with the recommendation of considering timing and previous exposures in the diagnosis of drug-associated rashes in pediatric population.