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

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.