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I would advise err on the side of caution ..
Have him take 2 Benadryl now if possible 25mg x2 pills
Go to ER
If he has light headed feeling or feels faint or short of breath then call 911
Main potential concern could be anaphylaxis with rash being hives to erythema multiforme ...
Mottled appearance of skin is of concern ...
Overall quick picture seems of concern to me in its worst potentials
That is why I advise immediate medical evaluation but less severe allergic reactions or other cause of rash are possible ..
Any fever ?
Any recent tick exposure ?
Bee sting ?
Unusual foods eaten ??
I hope that this is helpful for you
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Thank you and Best Regards ,