Author: Dr Ian Coulson, Dermatologist (2023)
Edited by the DermNet content department
This 40-year-old man has had three attacks of lesions which affect both his palms and soles. These attacks have occurred over the last three months, and last about 10 days.
This is recurrent erythema multiforme. He has some target-like lesions that are characteristic of this eruption.
Recurrent disease is usually triggered either by intermittent drug exposure, or herpes simplex infections which may be overt or covert.
It is important to accurately elucidate drug exposure history and seek symptoms of cold sores which can occur around the mouth, on the genitalia, or even affecting the uterine cervix.
The lesions of erythema multiforme can be treated by a super potent topical steroid which will reduce symptoms and hasten resolution. If evidence of herpes simplex as a trigger can be found, then suppressive long-term oral aciclovir may be an option if the eruption is sufficiently problematic and frequent to merit this. If a drug is suspected it should be avoided.
