A 5 year old girl who was referred to evaluate a possible amoxicillin allergy. About 3 years ago after the 8^th day of treatment with amoxicillin, she presented at the emergency room with a diffuse papular rash. This was her second exposure to amoxicillin. The symptoms lasted a few days. There was no involvement of mucosal membranes, no respiratory, gastrointestinal or cardiovascular symptoms Figure 1.

Figure 1: Drug rash

An amoxicillin challenge done at the clinic did not reveal any immediate response, but 7 days she presented with the rash exemplified in the photo. She did not complain on itchiness and the rash resolved after 5 days.

This is an example of a non-immediate likely T cell mediated reaction to amoxicillin Figure 2.

Figure 2: Drug rash