Yellow plaques on the trunk and limbs

This image shows multiple yellow, itchy, well demarcated, oedematous, and blanchable plaques with erythematous rims on the trunk and limbs of a woman in her 80s (fig 1). The lesions appeared a few hours after initiation of a meropenem infusion for aspiration pneumonia secondary to vomiting. At admission, laboratory results had shown raised levels of liver enzymes, bilirubin (6.4 mg/dL, normal range 0.3-1.0 mg/dL) and inflammatory markers, and a computed tomography scan confirmed a primary diagnosis of cholangitis secondary to gallstones.bmj;384/mar28_3/e077540/F1F1f1Fig 1Yellow urticaria manifests as yellow weals, often with erythematous rims, and is associated with hyperbilirubinaemia.1 The meropenem infusion was considered the cause of the urticaria, whereas the yellowness of the weals was attributed to the presence of extravasated plasma abundant in bilirubin.2 The transient and blanchable nature of the lesions accompanied by itching help to distinguish yellow urticaria from other conditions with similar presentations. Differential diagnoses include nodular amyloidosis,…
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