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Title: What's the Diagnosis? Case by Dr. Zachary Dezman

Category: Visual Diagnosis

Posted: 7/8/2013 by Haney Mallemat, MD

Question

3 year-old male develops rash 5 days after starting amoxicillin for acute otitis media. What's the diagnosis? 

Answer

Erythema Multiforme

Erythema multiforme (EM) is a pruritic, erythematous, and blanchable maculopapular rash; it is serpiginous or targetoid in shape, with central clearing or pallor.

EM is generally symmetric, appearing on hands, feet, groin, and extensor aspects of legs and forearms.

It is classically associated with upper respiratory infections, medications, connective tissue diseases, and malignancies.

Treatment includes:

  • stopping offending agent
  • symptomatic treatment (e.g. Benadryl for pruritis)
  • local wound care, especially if mucosal involvement

References

Habif, et al, Skin Disease, 3rd Ed. 2011

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