(1) The patient has a dermatophyte infection and often is being treated for it.
(2) The patient is hypersensitive to the dermatophyte with a positive delayed trichophytin skin test.
(3) The patient develops skin lesions away from the fungal lesions (the id reaction). These may be papules, vesicles, erythema nodosum, erythema or urticaria.
(4) No other diagnosis can explain the findings better.
(5) The reaction disappears once the dermatophyte has been eradicated.
The id reaction should not be misinterpreted as an adverse drug reaction and antifungal agents should not be discontinued because of it.
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