A patient presents with: widespread oral ulceration, hemorrhagic crusty lesions at the vermilion border of the lips, white wipeable plaque on tongue, and raised targetoid (target-shaped) lesions on the skin. The MOST likely diagnosis is:

Correct answer: D. Erythema multiforme (EM)

• A. MMP typically causes desquamative gingivitis and subepithelial blistering — not targetoid skin lesions or hemorrhagic lip crusting.
• B. Aphthous stomatitis causes discrete movable-mucosa ulcers — not widespread lesions with lip crusting and skin changes.
• C. SLE causes the butterfly facial rash, arthralgias, and mucosal lesions resembling LP — not acute targetoid lesions.
• D. Correct. The combination of: (1) widespread oral ulceration, (2) hemorrhagic crusting of the lips (very characteristic), (3) targetoid skin lesions, and (4) acute onset is classic for ERYTHEMA MULTIFORME. EM is a hypersensitivity reaction (often to HSV or drugs) causing immune-mediated keratinocyte destruction. The targetoid bullseye skin lesions are pathognomonic.