Differential Diagnosis for Target Lesions on Face

• Single most likely diagnosis
  • Erythema multiforme: This condition is characterized by target-like lesions on the skin, often appearing on the face, and is usually triggered by infections or medications. Its presentation matches the description closely, making it a prime candidate for the single most likely diagnosis.
• Other Likely diagnoses
  • Lupus erythematosus: This autoimmune disease can cause a variety of skin manifestations, including lesions that might resemble target lesions, especially in the context of a butterfly rash on the face.
  • Dermatomyositis: Although more commonly associated with muscle weakness, dermatomyositis can also present with skin lesions, including those on the face, which might be confused with target lesions.
  • Contact dermatitis: Certain allergens or irritants can cause skin reactions that might appear as target-like lesions, especially if the reaction is severe.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Stevens-Johnson syndrome (SJS) and Toxic Epidermal Necrolysis (TEN): These are severe skin conditions usually triggered by medications, leading to widespread skin necrosis and detachment. They can start with what appears to be target lesions but rapidly progress to life-threatening conditions.
  • Meningococcemia: This bacterial infection can cause a rash that might initially resemble target lesions, but it is a medical emergency due to the risk of sepsis and meningitis.
• Rare diagnoses
  • Sweet syndrome: Also known as acute febrile neutrophilic dermatosis, it can present with skin lesions that might be confused with target lesions, although it's more commonly associated with fever and neutrophilia.
  • Rowell syndrome: A rare condition characterized by lupus erythematosus-like symptoms, including skin lesions that might resemble target lesions, along with other systemic manifestations.