This 9-year-old girl had a 2 week history of increasing rash on her lips, hands, and feet. Although she was still drinking, she was having difficulty eating. Note the target lesions typical of erythema multiforme on her hands and feet. The mucous membranes of her mouth, eyes, nose, and genitals were clear. 50% of children with erytheme multiforme develop erosions on their lips and/or mouth resulting in decreased oral intake sometimes necessitating admission to the hospital for rehydration. Oral steroids were initiated with rapid improvement in her skin eruption and symptoms. Although the trigger in this child was not readily identified, she had an antecedent upper respiratory infection and either a viral or mycoplasma infection was suspected.
