Pathology · single question

Four weeks after the Type I reaction, the same patient develops target/bull's-eye skin lesions around their mouth. What is this condition and how is it managed?

  1. Stevens-Johnson syndrome — requires hospitalization
  2. Erythema multiforme — treated with corticosteroids
  3. Urticaria — treated with antihistamines
  4. Contact dermatitis — treated with emollients
Show answer and explanation

Correct answer: B. Erythema multiforme — treated with corticosteroids

  • A. Stevens-Johnson syndrome is erythema multiforme major with systemic involvement — requires hospitalization, but the board answer for typical delayed target lesion management is corticosteroids.
  • B. Correct. Target (bull's-eye) lesions appearing 2-4 weeks after a drug reaction (or following HSV reactivation) are ERYTHEMA MULTIFORME — a Type IV delayed hypersensitivity reaction. Treatment involves systemic corticosteroids to reduce the inflammatory response. Erythema multiforme minor has mucous membrane involvement and resolves; erythema multiforme major (Stevens-Johnson) is more severe.
  • C. Urticaria (hives) are raised, itchy welts — not target lesions.
  • D. Contact dermatitis presents as localized eczema-like reaction at the contact site — not target lesions.

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