In “Derm diagnoses you can’t afford to miss” (J Fam Pract. 2009;58:298-306), the authors state, “In an emergency setting, subcutaneous epinephrine (0.3-0.5 mg) can be useful in treating severe urticaria.” That is no longer the recommended route. Intramuscular (IM) administration, which results in more rapid absorption and more reliable blood levels of epinephrine, is now recommended for the treatment of emergent allergic reactions.1 The reference cited in the article from the British Association of Dermatologists also recommends IM epinephrine.2
Herbert L. Muncie, Jr, MD
LSU School of Medicine
New Orleans