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?:abstract
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Introduction: During the COVID-19 pandemic, multiple medications and supplements have received consideration for either prophylaxis and/or treatment This case describes an adverse reaction to the herbal medication Lomatium dissectum when it was used for prophylaxis against COVID-19 infection Case Description: A 57 y/o female presented with a 1 day history of a diffuse red, itchy rash She had been in good health prior to this Her only daily medications were magnesium and vitamins Six days prior to presentation, on the advice of a physician family member, she began taking Lomatium dissectum extract as prophylaxis against COVID-19 The day prior to her visit, she developed rapid onset, body wide rash that was intensely pruritic Physical exam: Afebrile patient in moderate distress secondary to pruritis from a diffuse maculopapular rash, sparing only the palms and soles No urticaria or angioedema Mucosal membranes without lesion Exam otherwise unremarkable Rapid strep was negative A literature review found a single case report with similar findings The Lomatium medication was stopped and she was treated with high dose antihistamine and prednisone Her rash resolved in 5 days, during which time she required another physician office visit and an emergency department evaluation for intense itching Discussion: In the herbal medication literature, Lomatium dissectum is characterized as an expectorant and treatment for febrile respiratory illnesses A rash that occurs in the first week of treatment, lasting for 5 days, is described as a possible side effect Allergists should be aware of this possible adverse drug reaction when evaluating patients for acute rash reactions
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