Man Has Targetoid Lesions on Hands, Legs, Arms, Soles – Let’s Diagnose

A 37-year-old man went to urgent care after he developed targetoid lesions all over both arms and legs, including his palms and soles. The lesions were well defined with 3 distinct color zones and a darker central area that on some lesions was a bulla and on some was more of a crust. He was alarmed because the lesions had appeared out of nowhere within just a few hours and were painful and itchy. He couldn’t remember feeling sick or being around anyone who had been sick recently. He didn’t remember any changes to his routine either, but his wife reminded him that he had been taking ibuprofen twice a day over the last week after tweaking his back during his weekly pick-up basketball game at the Y.

Is it erythema multiforme, fixed drug eruption, erythema annulare centrifugum, or urticaria?

Check out our differential on VisualDx.

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