Erythema Multiforme due to Herpes Labialis.

Herpes Labialis (Herpes Simplex Virus infection on the lips) may some times result in erythema multiforme minor with target lesions. In this patient lesion 1 is the healing herpes lesion and lesions 2 are due to erythema multiforme.

The mucosal involvement gives the appearance of Stevens-Johnson syndrome. Erythema multiforme is a mild, self-limited, often recurrent condition, whereas Stevens-Johnson syndrome is a severe, potentially life-threatening reaction. In the past, the two forms were believed to represent ends of a spectrum of disease, but now both are regarded as distinct entities. Stevens-Johnson syndrome is usually related to medication use.

Recurrent episodes, single mucosal involvement, lack of drug history and evidence of herpes labialis indicates that the patient is having EM Minor and is unlikely to proceed to the severe form in spite of mucosal involvement.

 

Lichen Planus masquerading as verruca vulgaris

This patient presented with lesions resembling warts on the palms. However lesion 1 near the wrist had the typical features of Lichen Planus. This is probably Lichen planus presenting as palmar keratoderma. There is a report of Clenched Fist Syndrome in a 16 year old girl with palmar lichen planus.

Lichen Striatus