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Acute Care Casebook

Kara Cockrum

, and David Mills


This case reviews the presentation of a pediatric patient with target lesions on the skin and mucous membrane involvement. Creating a focused differential diagnosis for patients with these symptoms is essential, as diagnoses range from self-limited illnesses treated with supportive care to life-threatening diseases requiring intensive care. Recognizing discriminating features of erythema multiforme (EM) minor, EM major, Stevens-Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN) is critical when assessing a patient with concerning skin and mucosal findings. This case reviews the classic clinical features of EM and key features that differentiate it from conditions with high morbidity and mortality such as SJS and TEN. It focuses on the recognition of precipitating factors, the diagnostic workup, and the hallmarks of management for patients with EM.

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