December 29, 2024

A 14-year-old boy presents with diffuse skin disease

By Med-Challenger · 1 minute read

A 14-year-old boy presents with diffuse skin disease and several doughnut-shaped papules that have an erythematous border and pale inner rings (see Figure).

image (50)

Figure.

Upon physical examination of his hands, you note a palmar eruption comprised of papules with central necrosis.

Which of the following conditions is the most likely in this patient?

erythema multiforme
dyshidrotic eczema
Stevens-Johnson syndrome
secondary syphili

The correct answer is:

erythema multiforme

Educational Objective:

Identify the characteristic skin lesions of erythema multiforme.

Explanation:

This patient likely has erythema multiforme, which may involve a range of dermatologic symptoms that include erythematous macules, papules, vesicles and bullae. Although most of these symptoms are asymptomatic, some may present with a burning sensation or pruritus. The classic lesion of erythema multiforme has target-like papules with an erythematous outer border and a pale inner ring. The inner ring may have a necrotic center that could develop into blisters.

Reference:

Joyce, J. Vesiculobullous disorders. In: Kliegman RM, et al. Nelson Textbook of Pediatrics. 20th ed., 2015:3140-3150.

This question appears in Med-Challenger Physician Assistant Exam Review with CME

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