Podcast 656: Rashes

<p><strong>Contributor:  Peter Bakes, MD</strong></p> <p><strong>Educational Pearls:</strong></p> <ul> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Lyme disease gives a single expanding target lesion with central clearing called erythema chronicum migrans</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Erythema multiforme is another targetoid rash that presents with multiple target lesions</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Characterized into erythema minor and major based on severity but typically resolves</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">More severe hypersensitivity reactions include Stevens-Johnson Syndrome (<10% skin involvement), or Toxic Epidermal Necrolysis (>30% skin involvement)</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">SJS and TEN is associated with NSAIDS including aspirin, antiemetics like phenergan, anticonvulsants like dilantin or phenobarbital, and antibiotics like penicillin or sulfa drugs</span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Other causes include viral illnesses like Herpes simplex virus or mycoplasma pneumoniae </span></li> <li style="font-weight: 400;" aria-level="1"><span style= "font-weight: 400;">Treat by removing offending agent and treat supportively with monitoring for rash progression to SJS or TEN</span></li> </ul> <p><strong>References</strong></p> <p><span style="font-weight: 400;">Trayes KP, Love G, Studdiford JS. Erythema Multiforme: Recognition and Management. Am Fam Physician. 2019 Jul 15;100(2):82-88. PMID: 31305041.</span></p> <p><span style="font-weight: 400;">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.</span></p> <p><em><span style="font-weig