A 55-year-old woman had a 10-day history
of a nonproductive cough and a
painful rash on both palms for 5 days.
The eruption subsequently spread
over her entire body.
Erythema multiforme--a reactive
dermatosis exacerbated by a variety
of stimuli--was diagnosed. The
hive-like rash is more tender than
pruritic and features bull's-eye lesions.
The 2 classic infectious causes are
herpes simplex virus and Mycoplasma
pneumoniae. Further evaluation of
the patient confirmed the mycoplasmal
source; the infection responded to
appropriate antibiotic therapy.
The skin eruption improved dramatically
after a few days of systemic
(Case and photograph courtesy of Dr David L. Kaplan.)