What is the differential diagnosis of Erythema Multiforme (EM)?

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Differential Diagnosis for Erythema Multiforme

  • Single most likely diagnosis
    • Urticaria: This condition is often considered in the differential diagnosis due to its similar presentation of skin lesions, although urticaria typically lacks the targetoid appearance characteristic of erythema multiforme.
  • Other Likely diagnoses
    • Stevens-Johnson Syndrome (SJS): A severe skin and mucous membrane disorder, usually a reaction to medication or infection. It's distinguished from erythema multiforme by the extent of skin detachment and mucosal involvement.
    • Toxic Epidermal Necrolysis (TEN): Similar to SJS but with more widespread skin detachment. It's a medical emergency and must be differentiated from erythema multiforme due to its high mortality rate.
    • Fixed Drug Eruption: A condition characterized by skin lesions that occur at the same site each time a particular drug is taken. The lesions can resemble those of erythema multiforme but are typically fewer in number and recur at the same sites.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis (SJS/TEN): Although mentioned under other likely diagnoses, it's crucial to reiterate here due to its potential for high morbidity and mortality if not promptly recognized and treated.
    • Autoimmune Bullous Diseases (e.g., Pemphigus, Pemphigoid): These conditions can present with blistering skin lesions and, although less common, can be severe and require specific treatments.
  • Rare diagnoses
    • Rowell's Syndrome: A rare condition characterized by erythema multiforme-like lesions in association with lupus erythematosus.
    • Paraneoplastic Pemphigus: A rare autoimmune disorder associated with underlying neoplasia, presenting with severe mucosal lesions and skin blistering.
    • Acute Generalized Exanthematous Pustulosis (AGEP): Characterized by numerous small, sterile pustules on the skin, often accompanied by fever and leukocytosis, typically triggered by medications.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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