Dermoscopy of erythema multiforme.

A 17-year-old male patient presented with a 4-day history of raised, reddish skin lesions on multiple sites of the body. There was mild fever. On examination, typical target lesions were seen mainly over the palms and soles. A clinical diagnosis of erythema multiforme was made. Dermoscopy of a typical target lesion over the right palm [Figure 1] (polarized light, ×10, DermliteFoto II pro, attached to a Canon 650D – DSLR) showed clods of different colors – red, blue, purple, and black, corresponding to the central dusky zone (white arrow), a plain featureless area corresponding to the pale edematous zone (yellow arrow), and homogenous erythema corresponding to the outer red ring (black arrow). A few short linear vessels were also seen [Figure 2].

Figure 1

Clinical appearance of a typical target lesion on the palm

Figure 2

Dermoscopy of typical target lesion in erythema multiforme: White arrow corresponding to the central dusky zone shows clods of different colors – red, blue, purple, and black. The yellow arrow shows a plain featureless area corresponding to the pale edematous zone, and the black arrow shows homogenous erythema corresponding to the outer red ring. A few short linear vessels were also seen (polarized light, ×10, DermliteFoto II pro, attached to a Canon 650D – DSLR)

The typical target or iris lesions are characterized by three concentric zones – a central dusky zone, surrounded by a ring of pale edema and a peripheral red rim. There is minimal literature on the dermoscopy of erythema multiforme; bluish patches corresponding to the dusky centre and homogenous erythema corresponding to the peripheral erythematous rim have been described.[1] The image is presented to highlight the dermoscopic correlates of a typical iris lesion in erythema multiforme.

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