Rosh Pediatrics Practice Exam

What is the suspected condition of an 8-year-old girl presenting with a rash characterized by erythematous lesions with a dusky central area?

1. Arythema marginatum

2. Berrythema migrans

3. Cerythema multiforme

4. DStevens-Johnson syndrome

The correct answer is: Cerythema multiforme

The presentation of erythematous lesions with a dusky central area in an 8-year-old girl is suggestive of erythema multiforme. This condition is characterized by target lesions that often develop on the skin, and the classic appearance includes a central area of dusky or necrotic skin surrounded by a ring of erythema. This distinctive morphology is a hallmark of erythema multiforme and helps differentiate it from other dermatological conditions. In contrast, erythema marginatum is typically associated with rheumatic fever and presents as pink, non-itchy lesions that do not have a central dusky area. Lyme disease's characteristic rash, known as erythema migrans, usually appears as a red expanding lesion with central clearing, often without a dusky center, and is linked to tick bites. Stevens-Johnson syndrome presents with more severe skin involvement and mucosal ulceration, making it more acutely life-threatening and typically affects areas like the mouth and eyes alongside skin lesions. Thus, the unique presentation of lesions with a dusky center in this scenario supports the diagnosis of erythema multiforme.