--- title: A 14-year-old boy presents with diffuse skin disease description: It's Maculopapular Lesion Quiz Time with Med-Challenger! image: https://challengercme.com/hubfs/image%20(50).png --- [![Med-Challenger-green-logo-1024x244](https://challengercme.com/hubfs/Med-Challenger-green-logo-1024x244.webp) ](https://challengercme.com/) - [SHOP EXAM PREP & CME ](https://challengercme.com/blog/a-14-year-old-boy-presents-with-diffuse-skin-disease#) ### [EMERGENCY MEDICINE](https://challengercme.com/emergency-medicine-exam-review-cme-course) [ABEM exam prep](https://challengercme.com/emergency-medicine-exam-review-cme-course), [MyEMCert](https://challengercme.com/emergency-medicine-myemcert-exam-review-course), etc. ### [FAMILY MEDICINE](https://challengercme.com/family-medicine-exam-review-cme-course) [ABFM exam prep](https://challengercme.com/family-medicine-exam-review-cme-course), [ABFM KSA](https://challengercme.com/family-medicine-moc-ksa-course), etc. ### [INTERNAL MEDICINE ABIM exam prep, MOC points, etc.](https://challengercme.com/internal-medicine-exam-review-cme-course) ### [OBGYN ABOG exam prep, CREOG, etc.](https://challengercme.com/obgyn-exam-review-cme-course) ### [PEDIATRICS ABP exam prep, MOCA-PEDS, etc.](https://challengercme.com/pediatric-medicine-exam-review-cme-course) ### [PEDIATRIC EM](https://challengercme.com/pediatric-emergency-medicine-3rd-edition) [ABP/ABEM exam prep Ed.3](https://challengercme.com/pediatric-emergency-medicine-3rd-edition), [Ed.2](https://challengercme.com/pediatric-emergency-medicine-pack2), etc. ### [SPECIAL PURPOSE / SPEX FSMB exam prep, etc.](https://challengercme.com/special-purpose-exam-review-spex-exam-preparation-course) ### [PHYSICIAN ASSISTANT](https://challengercme.com/physician-assistant-exam-review-cme-course) [PANCE / PANRE](https://challengercme.com/physician-assistant-exam-review-cme-course), [CAQ-EM](https://challengercme.com/pa-caq-em-review-course), etc ### [NURSE PRACTITIONER](https://challengercme.com/family-nurse-practitioner-exam-review-cme-course) [FNP](https://challengercme.com/family-nurse-practitioner-exam-review-cme-course), [ENP](https://challengercme.com/emergency-nurse-practitioner-exam-review-cne-course), [AGNP](https://challengercme.com/adult-gerontology-nurse-practitioner-exam-review-cne-course), [PNCB/CPNP](https://challengercme.com/pediatric-nurse-practitioner-exam-review-cne-course), etc. ### [NURSING / NCLEX NCLEX, CNE, etc.](https://challengercme.com/nursing-certification-nclex-exam-review-cne-courses) ### [STATE-REQUIRED CME / CE State CME requirements, etc.](https://challengercme.com/state-required-cme) ### [JOINT COMMISSION CME](https://challengercme.com/stroke-center-ce-review-course) [Stroke](https://challengercme.com/stroke-center-ce-review-course), [Cardiac](https://challengercme.com/cardiac-center-ce-review-course), [Trauma](https://challengercme.com/trauma-center-ce-review-course), [ALS](https://challengercme.com/advanced-life-support-and-resuscitation-center-ce-review-course), etc. ### [PROFESSIONALISM CME Professionalism review with CME](https://challengercme.com/professionalism-review-course) ### [DERMATOLOGY CME Dermatology review with CME](https://challengercme.com/dermatology-review-course) ### [USMLE STEP 2CK / STEP 3 USMLE exam prep, etc.](https://challengercme.com/usmle-certification-exam-review-clerkship-exams-shelf-exam-review) - [INSTITUTIONS ](https://challengercme.com/atlas-pro-inst) - [BLOG ](https://challengercme.com/blog) - [SUPPORT ](https://support.challengercme.com/knowledge) [SIGN IN ](https://fuse.challengercme.com/sign-in?redirectURL=%2Fuserdash) quick quiz # A 14-year-old boy presents with diffuse skin disease It's Maculopapular Lesion Quiz Time with Med-Challenger! [ Med-Challenger ](https://challengercme.com/blog/author/med-challenger) Dec 29, 2024 [Personal Education](https://challengercme.com/blog/tag/personal-education) [Physician Assistant](https://challengercme.com/blog/tag/physician-assistant) [Question of the Week](https://challengercme.com/blog/tag/question-of-the-week) [quick quiz](https://challengercme.com/blog/tag/quick-quiz) ### < [All Posts](https://challengercme.com/blog) Try Med-Challenger Start a free trial today and save! Pass-guaranteed board exam review with CME/CE credits built-in. Target weak areas, study smarter, stay on track. Act now and save. [BROWSE COURSES](https://fuse.challengercme.com/store) --- ### Share this article [mailto:?subject=Check%20out%20https://challengercme.com/blog/a-14-year-old-boy-presents-with-diffuse-skin-disease&utm_medium=social&utm_source=email%20&body=Check%20out%20https://challengercme.com/blog/a-14-year-old-boy-presents-with-diffuse-skin-disease&utm_medium=social&utm_source=email](mailto:?subject=Check%20out%20https://challengercme.com/blog/a-14-year-old-boy-presents-with-diffuse-skin-disease&utm_medium=social&utm_source=email%20&body=Check%20out%20https://challengercme.com/blog/a-14-year-old-boy-presents-with-diffuse-skin-disease&utm_medium=social&utm_source=email) ### Subscribe ### Subscribe ![A 14-year-old boy presents with diffuse skin disease](https://challengercme.com/hubfs/image%20(50).png) 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)](https://challengercme.com/hs-fs/hubfs/image%20(50).png?width=433&height=271&name=image%20(50).png) *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](https://challengercme.com/physician-assistant-exam-review-cme-course) [Try for free and save](https://fuse.challengercme.com/fulltrial/204). Ace your exams and meet your CME/MOC requirements for just $26 a month! [![subcription_icon_pa-e1519157433195-3](https://challengercme.com/hs-fs/hubfs/Imported_Blog_Media/subcription_icon_pa-e1519157433195-3.png?width=250&height=256&name=subcription_icon_pa-e1519157433195-3.png)](https://challengercme.com/physician-assistant-exam-review-cme-course) [![QuizButton-1](https://challengercme.com/hs-fs/hubfs/QuizButton-1.jpg?width=235&height=81&name=QuizButton-1.jpg)](https://challengercme.com/blog/30-year-old-woman-presents-with-persistently-high-blood-pressure) --- No matter your program, no matter the size, [Med-Challenger for Groups and Institutions](https://challengercme.com/institutional-medical-education-for-groups) can better prepare your program or group, fulfill industry requirements, and increase test scores.   For personal medical education that includes board's prep, MOC, and CME requirements, Med-Challenger has you covered in [Family Medicine](https://challengercme.com/family-medicine-exam-review-cme-courses), [Emergency Medicine](https://challengercme.com/emergency-medicine-exam-review-cme-courses), [Internal Medicine](https://challengercme.com/internal-medicine-exam-review-cme-courses), [Pediatrics](https://challengercme.com/pediatric-medicine-exam-review-cme-courses), [Pediatric Emergency Medicine](https://challengercme.com/category-pediatric-emergency-medicine-courses), [OBGYN](https://challengercme.com/obgyn-exam-review-cme-courses), [Physician Assistants](https://challengercme.com/physician-assistant-exam-review-cme-courses), and [Nurse Practitioners.](https://challengercme.com/nurse-practitioner-exam-review-cme-courses)   Never miss a thing. Subscribe to our blog and save! [![SUBSCRIBE Medical Education Blog & Newsletter](https://no-cache.hubspot.com/cta/default/9106197/703c79e6-b750-4dfa-acfa-b6ca5307c563.png)](https://cta-redirect.hubspot.com/cta/redirect/9106197/703c79e6-b750-4dfa-acfa-b6ca5307c563)   ## Similar posts internal medicine ### [An 88-year-old man with a history of diabetes, hypertension, and stage 4 chronic kidney disease](https://challengercme.com/blog/an-88-year-old-man-with-a-history-of-diabetes-hypertension-and-stage-4-chronic-kidney-disease) It's Kidney Disease Quiz Time with Med-Challenger! Med-Challenger Jan 13, 2025 internal medicine ### [Morbidly obese 75-year old with diabetes mellitus](https://challengercme.com/blog/mordidly-obese-75-year-old-with-diabetes-mellitus) It's Diabetes Mellitus Quiz Time with Med-Challenger! Med-Challenger Nov 18, 2024 quick quiz ### [A newborn vomits after each feeding and starts to develop abdominal distension](https://challengercme.com/blog/a-newborn-vomits-after-each-feeding-and-starts-to-develop-abdominal-distension) It's Newborn Quiz Time with Med-Challenger! Med-Challenger Jan 10, 2025 ## Stay informed. ### Subscribe to our [Medical Education Blog](https://challengercme.com/blog)  Stay informed of new medical education content, certification requirements and deadlines, case-based CME quizzes, and special offers. [![Med-Challenger-green-logo-1024x244](https://challengercme.com/hubfs/Med-Challenger-green-logo-1024x244.webp) ](https://challengercme.com) #### **Online Medical Education** 1-800-676-0822 Sales - Option 1 Support - Option 2   ### Company - [Get Support](https://support.challengercme.com/knowledge/kb-tickets/new) - [Policies](https://support.challengercme.com/knowledge) - [Special Offers](https://challengercme.com/special) ### Products - [Exam Prep & CME](https://challengercme.com/med-challenger-free-trial-landing-page) - [Institutional LMS](https://challengercme.com/atlas-pro-inst) ### Resources - [CME Blog](https://challengercme.com/blog) - [Knowledge Base](https://support.challengercme.com/knowledge) ### Account - [Create Account](https://fuse.challengercme.com/sign-up) - [Login](https://fuse.challengercme.com/sign-in?redirectURL=%2Fuserdash) © 2026 Challenger Corporation. All rights reserved [Privacy Policy](https://support.challengercme.com/knowledge/what-are-your-terms-of-service-privacy-policy-user-agreement) ```json { "@context" : "https://schema.org", "@id" : "https://challengercme.com/blog#webpage", "@type" : "WebPage", "description" : "The Challenger Medical Education Blog offers informative patient cases, medical certification exam preparation courses and board exam review tips.", "inLanguage" : "en", "isPartOf" : { "@type" : "WebSite", "name" : "Med-Challenger", "url" : "https://challengercme.com/" }, "mainEntityOfPage" : { "@id" : "https://challengercme.com/blog", "@type" : "WebPage" }, "name" : "Challenger Medical Education Blog", "primaryImageOfPage" : { "@type" : "ImageObject", "url" : "https://challengercme.com/hubfs/Webpage%20Featured%20Images/Medical%20Education%20Blog%20-%20Free%20CME%20resources%2c%20certification%20exam%20tips%2c%20clinical%20challenge%20questions%20and%20more.png" }, "publisher" : { "@type" : "Organization", "name" : "Challenger Corporation", "url" : "https://challengercme.com/" }, "url" : "https://challengercme.com/blog" } ``` ```json { "@context" : "https://schema.org", "@type" : "Article", "about" : [ "erythema multiforme", "target lesions", "macules", "papules", "vesicles", "bullae", "palmar eruption", "necrotic center", "vesiculobullous disorders", "pediatric dermatology", "medical education", "exam preparation", "CME", "Physician Assistant exam review" ], "articleSection" : "Pediatric Medicine", "author" : { "@type" : "Organization", "name" : "Challenger Corporation" }, "dateModified" : "2024-12-29T15:30:01.141Z", "datePublished" : "2024-12-29T15:30:00.000Z", "description" : "It's Maculopapular Lesion Quiz Time with Med-Challenger! A medical-education, exam-preparation quiz asking identification of characteristic target-like lesions of erythema multiforme in a pediatric patient.", "headline" : "A 14-year-old boy presents with diffuse skin disease", "image" : [ { "@type" : "ImageObject", "description" : "Figure: doughnut-shaped target-like papules with erythematous border and pale inner rings; inner ring may have a necrotic center, as described in the article." } ], "inLanguage" : "en-US", "keywords" : [ "erythema multiforme", "target lesions", "maculopapular", "palmar eruption", "pediatric dermatology", "vesiculobullous", "dermatology quiz", "Med-Challenger", "physician assistant exam review", "CME" ], "mainEntityOfPage" : { "@id" : "https://challengercme.com/blog/a-14-year-old-boy-presents-with-diffuse-skin-disease", "@type" : "WebPage" }, "publisher" : { "@type" : "Organization", "logo" : { "@type" : "ImageObject", "url" : "https://challengercme.com/logo.png" }, "name" : "Challenger Corporation" } } ``` ```json { "@context" : "https://schema.org", "@type" : "QAPage", "mainEntity" : { "@type" : "Question", "acceptedAnswer" : { "@type" : "Answer", "text" : "Erythema multiforme. The presentation is characteristic for erythema multiforme: classic target-like papules with an erythematous outer border and a pale inner ring. The inner ring may have a necrotic center and lesions can progress to vesicles or bullae. (Educational objective: identify the characteristic skin lesions of erythema multiforme.)" }, "name" : "Which condition is most likely given doughnut-shaped papules with erythematous borders and pale inner rings?", "text" : "A 14-year-old boy presents with diffuse skin disease and several doughnut-shaped papules that have an erythematous border and pale inner rings. On 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? Options: erythema multiforme; dyshidrotic eczema; Stevens-Johnson syndrome; secondary syphilis." } } ``` ```json { "@context" : "https://schema.org", "@type" : "ItemList", "description" : "Exam-style review questions based on this article’s teaching points.", "itemListElement" : [ { "@type" : "ListItem", "item" : { "@type" : "Question", "acceptedAnswer" : { "@type" : "Answer", "text" : "Erythema multiforme: classic target-like papules with an erythematous outer border and a pale inner ring; the inner ring may have a necrotic center and lesions can progress to vesicles or bullae." }, "name" : "Identify the most likely diagnosis for target-like doughnut-shaped papules with erythematous borders and pale inner rings." }, "position" : 1 } ], "name" : "Practice Questions", "numberOfItems" : 1 } ```