Contributor: Peter Bakes, MD
- Lyme disease gives a single expanding target lesion with central clearing called erythema chronicum migrans
- Erythema multiforme is another targetoid rash that presents with multiple target lesions
- Characterized into erythema minor and major based on severity but typically resolves
- More severe hypersensitivity reactions include Stevens-Johnson Syndrome (<10% skin involvement), or Toxic Epidermal Necrolysis (>30% skin involvement)
- SJS and TEN is associated with NSAIDS including aspirin, antiemetics like phenergan, anticonvulsants like dilantin or phenobarbital, and antibiotics like penicillin or sulfa drugs
- Other causes include viral illnesses like Herpes simplex virus or mycoplasma pneumoniae
- Treat by removing offending agent and treat supportively with monitoring for rash progression to SJS or TEN
Trayes KP, Love G, Studdiford JS. Erythema Multiforme: Recognition and Management. Am Fam Physician. 2019 Jul 15;100(2):82-88. PMID: 31305041.
Read J, Keijzers GB. Pediatric Erythema Multiforme in the Emergency Department: More Than “Just a Rash”. Pediatr Emerg Care. 2017 May;33(5):320-324. doi: 10.1097/PEC.0000000000000618. PMID: 26555305.
Summarized by John Spartz, MS3 | Edited by Erik Verzemnieks, MD
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