A rash is a rash is a rash, right? Not quite! The target-shaped spots of erythema multiforme may be unlike any other rash you've ever seen.
Erythema multiforme is a hypersensitive reaction to an infection or, in some cases, a medication. This reaction causes red, target-shaped or "bulls-eye" patches or sores on the skin. The rash usually starts off looking like pink or red blotches that develop over a few days into round shapes that look like targets (with red, pink, and pale rings). They sometimes have blisters or scabs in the center.
The rash usually begins on the arms, hands, legs, and feet, but you might also find it on the face, neck, and body. It also can affect the lips and inside the mouth.
One of the characteristics of an erythema multiforme rash is that it develops on both sides of the body. So a kid who gets it on one leg will probably get it on the other leg too. Kids will typically complain that the rash itches and may even burn. As the rash goes away, it may turn a brownish color.
The rash, which usually develops quickly, may be the only sign that a child has the condition. However, sometimes kids may also feel tired or have:
Most cases of erythema multiforme are believed to be a reaction to an infection that causes the body's immune system to damage the skin cells. More than half of cases are associated with the herpes simplex virus, the virus that causes cold sores. But bacteria like mycoplasma, fungi, and other viruses are also triggers for the rash.
Erythema multiforme can occur after taking certain medications — although medications are a less likely cause than an infection. Some of the medications that can trigger a reaction are:
In addition, some cases occur after a child has received an immunization, such as the tetanus-diphtheria-acellular pertussis (Tdap) or hepatitis B vaccines.
The condition is not contagious, so cannot be passed from one person to another.
A doctor is usually able to recognize erythema multiforme just by looking at it. To help figure out what caused it, the doctor will ask about any recent infections your child may have had and any medications he or she is taking. Sometimes it's not obvious what's causing the rash, but a doctor can still treat the problem.
Erythema multiforme goes away on its own without treatment. In many cases, though, the doctor will try to treat whatever caused your child to have the reaction. So if a bacterial infection is thought to be behind the rash, the doctor may recommend that your child take an antibiotic. If a medication is the likely culprit, the doctor probably will have your child stop taking it and replace it with another medication, as needed.
To help make your child feel better, the doctor may recommend:
Although these treatments provide relief, they do not shorten the duration of the rash.
Most kids who get erythema multiforme have no long-term effects. The rash usually goes away in 1 to 2 weeks, but can last as long as 4 weeks. It doesn't cause scarring, but in some kids might leave darker spots on the skin for a few months.
An erythema multiforme rash may come back again (recur) after going away, especially if a child is re-exposed to whatever caused the initial outbreak (so, for example, a child may need to avoid certain medicines). If the herpes simplex virus is causing repeated episodes of erythema multiforme, a doctor may prescribe a daily antiviral medicine to prevent recurrences.
Reviewed by: Kate M. Cronan, MD
Date reviewed: May 2012
|American Academy of Pediatrics (AAP) The AAP is committed to the health and well-being of infants, adolescents, and young adults. The website offers news articles and tips on health for families.|
|American Academy of Dermatology Provides up-to-date information on the treatment and management of disorders of the skin, hair, and nails.|
|National Eczema Association This site contains information about eczema, dermatitis, and sensitive skin.|
|Word! Bacteria If you're feeling crummy, it's probably because nasty bacteria or some other germs have gotten into your body and made you sick.|
|Hand Washing Did you know that the most important thing you can do to keep from getting sick is to wash your hands? If you don't wash your hands frequently, you can pick up germs from other sources and then infect yourself.|
|Why Should I Care About Germs? Germs are tiny organisms that can cause disease - and they're so small that they can creep into your system without you noticing. Find out how to protect yourself.|
|Lyme Disease Lyme disease can affect the skin, joints, nervous system, and other organ systems. If diagnosed quickly and treated with antibiotics, Lyme disease in kids is almost always treatable.|
|Rashes: The Itchy Truth Learn about rashes in a flash. Check out our article just for kids!|
|Lyme Disease The best way to prevent Lyme disease is to prevent tick bites. Find out more about this disease and how to keep those ticks away.|
|Henoch-Schönlein Purpura (HSP) Most kids who develop this inflammation of the blood vessels (marked by a raised red and purple rash) make a full recovery and have no long-term problems.|
|Erythema Toxicum Erythema toxicum is a common harmless rash that appears in at least half of all full-term infants. No treatment is needed and it goes away on its own.|
|Cold Sores Cold sores are small and painful blisters that appear around the mouth, face, or nose. They're very common and, while uncomfortable, usually go away on their own.|
|Coping With Cold Sores You may have had a cold sore, but what are they exactly? Find out in this article for kids.|
|Lyme Disease Lyme disease can be treated if it's caught early. So read this to find out what causes it, how it's treated, and how to prevent it.|
|Fungal Infections What do you think of when you hear the word fungus? Do you think of mushrooms? A mushroom is one type of fungus, but fungus is also a type of germ that lives on all of us.|
|First Aid: Rashes Sometimes rashes are only a minor annoyance. Other times, they are more serious and require medical treatment. Here's what to do if your child has a rash.|
|What Are Germs? You know they can hurt you, but what are these invisible creatures? Find out in this article for kids.|
|What Are Germs? Germs are the microscopic bacteria, viruses, fungi, and protozoa that can cause disease. With a little prevention, you can keep harmful germs out of your family's way.|
|Pityriasis Rosea Pityriasis rosea is a pink or gray skin rash that's common in teens and young adults. It may itch, but it's harmless. Find out what to do about it in this article for teens.|
|Pityriasis Rosea This harmless rash often forms a telltale "Christmas tree" pattern on the back that makes it easy to identify.|
|Cold Sores (HSV-1) Cold sores (also known as fever blisters) are pretty common and lots of people get them. So what causes them and what can you do?|
|Hives (Urticaria) Has your child broken out in welts? It could be a case of the hives. Learn how to soothe itchy bumps and help your child feel better.|
|Hives (Urticaria) Hives cause raised red bumps or welts on the skin. They're pretty common and usually not serious. Find out what to do about hives in this article for teens.|
What to expect when coming to Akron Children's
For healthcare providers and nurses
Residency & Fellowships, Medical Students, Nursing and Allied Health
For prospective employees and career-seekers
Our online community that provides inspirational stories and helpful information.