A mild, self-limited, potentially recurring mucocutaneous inflammatory condition.
Characterized by target lesions that resemble a bull's eye. These usually erupt over 24 to 48 hours and last for 1 to 2 weeks.
Typically presents in a symmetrical distribution of lesions over the dorsal surfaces of the extensor extremities with minimal mucous membrane involvement.
Generally related to infectious diseases and not drug exposure. The most commonly associated infections are herpes simplex virus and Mycoplasma pneumoniae. Other associated infections include hepatitis B, Epstein-Barr virus, cytomegalovirus, histoplasmosis (with concomitant erythema nodosum), orf (parapox virus that can be transmitted from sheep or goats to humans), coccidiodomycosis, Kawasaki disease, and gardnerella.
Associated drugs include aminopenicillins, docetaxel, TNF-alpha inibitors, antimalarials, anticonvulsants, and lidocaine injections. Statin medications have been associated with photo-induced lesions. Hepatitis B vaccine and allergic response to contact allergens have also been known to elicit the disorder.
Supportive care and treatment of underlying infection remain the mainstay of therapy.
Palmar target lesions
From the personal collection of Nanette Silverberg, MD, FAAD, FAAP