Erythema multiforme

QUESTION 9

A 29-year-old man presents to the ED with a generalized rash that began on the arms and chest and spread to involve the palms, face and back. He was seen by his primary care physician 5 days ago for the development of cold sores and was prescribed oral acyclovir. He denies treatment with any other new medications and has no other medical problems. On examination, there are erythematous, raised papules on the face, back and extremities with a violaceous hue, some with a targetoid appearance (9a, b). Other than a resolving herpetic blister on the vermillion border of the lower lip, there are no signs of mucosal or intraoral involvement.