Out of Sight, Out of Mind - Patient History in Disseminated Drug Exanthems from "Forgotten" over the Counter Medication, a Tough Nut to Crack

Two patients are presented who were referred for evaluation of unclear exanthema, in both of whom the diagnosis was not initially made. The first patient had a disseminated drug exanthema, the female patient a generalized fixed drug exanthema. The extensive allergological diagnostic work-up performed because of a suspected drug allergy was first negative. In both cases, the trigger was initially not obtained in the patient's history, because both patients had forgotten the self-therapy with over-the-counter medications or considered it irrelevant. Only after intensive questioning could the triggers pseudoephedrine and paracetamol, respectively, be identified and confirmed. The central role of a comprehensive history collection and documentation of all therapeutic agents taken is discussed.