SEVERE SKIN reactions/conditions are of particular concern when the traveler is away from home and medical care is unfamiliar or of uncertain caliber. Perhaps the most significant of these conditions is Stevens–Johnson syndrome, which may occur after the use of antimalarials such as Fansidar® as prophylaxis while traveling in Africa. Travel remains a rapidly growing enterprise with more remote destinations appearing on the radar screen each year, making the previous review a basis for this update.

More commonly, a serious dermatosis begins before the trip, progresses, and becomes significant while the traveler is away from usual medical care, not following his or her usual dietary and health habits, and often has a difficult time finding and/or communicating with medical personnel. Older patients (often the usual travelers with both time and means) have particular challenges – daunting lists of drugs and potential interactions, as well as the possibility of new drugs (and side effects) beginning around the time of the travel. The pediatric population is part of this new trend, and the smaller patients have higher risk in both toxic (venoms) and drug reactions. The occasional traveler rarely keeps important medical documents with him or her, but they are necessary during an acute/life-threatening event, as the following example demonstrates.