Differential Diagnosis for Symmetrical Red Papular Rash with Many Target Lesions
- Single most likely diagnosis
- Erythema Multiforme (EM): This condition is characterized by the presence of target lesions, which are a hallmark of the disease. The symmetrical distribution and the presence of many target lesions make EM a strong candidate for the diagnosis.
- Other Likely diagnoses
- Stevens-Johnson Syndrome (SJS): Although SJS is more severe and often involves mucous membranes, it can present with similar skin lesions. The presence of target lesions and a symmetrical rash could suggest SJS, especially if there are other systemic symptoms.
- Urticaria: While urticaria typically presents with wheals, some cases can have a more papular appearance. However, the presence of target lesions is less common in urticaria.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Toxic Epidermal Necrolysis (TEN): TEN is a severe condition with a high mortality rate. It can present with a similar rash, including target lesions, and it is crucial to distinguish it from other conditions due to its severity and the need for prompt treatment.
- Rocky Mountain Spotted Fever (RMSF): This tick-borne illness can present with a rash that includes target lesions. Although less common, RMSF is a critical diagnosis to consider due to its potential severity and the need for specific treatment.
- Rare diagnoses
- Sweet Syndrome: Also known as acute febrile neutrophilic dermatosis, Sweet Syndrome can present with a papular rash but is less commonly associated with target lesions. It is a rare condition that could be considered in the differential diagnosis.
- Rowell Syndrome: A rare condition characterized by a lupus-like syndrome with a distinctive rash that includes target lesions. It is an uncommon diagnosis but should be considered in patients with a suggestive clinical presentation.