Scarring from a severe case of Erythema Multiforma

My 12 year old, very light skinned, daughter had a severe case of erythema multiforma involving most of her body in September and October of 2001.  She was originally and repeatedly diagnosed with ringworm and treated with topical, over the counter anti fungal drugs.  In mid October, her pediatirician suggested that we cover her completely in Selsum Blue shampoo for several hours each night to clear up the increasing "ringworm" infection.  After two days of this treatment, her skin was almost completely covered with raised, broken, painful and itchy patches, as well as hives.  We returned to the doctor, and another physician immediately diagnosed it as erythema multiform and put her on cortisone treatments.  The cortisone worked quickly, and the rash improved.  However, I am starting to be concerned that the white spots all over her arms and legs where the patches were are going to be permanent.  When I asked the same pediatrician who originally misdiagnosed the rash, she told me that it would take a while, but would clear up.  She indicated that it might be a couple of years.  As these spots literally cover all but her face, I would like to hear your opinion.  Also, is there anything we can do to even out her skin tone?  Is she at increased risk of sun damage to her skin?

[Alan Rockoff, MD]

There is much in your story which does not quite hang together.  Erythema multiforme does not, for instance, cover the face or whole body.  Not does it typically leave "white spots."

More likely, it seems to me, is that your daughter had a flare of eczema.  This can rpoduce round, scaly patches which leave hypopigmenation (undercoloration).  This can last for months before evening out, but it does even out, and all by itself.

Selsun cannot damage the skin permanently.  The white spots do not represent damage or the potential for sun damage.

I advise you to have your daughter consult a dermatologist, who can perhaps look at her skin under a Woods light (a hand-held ultraviolet diagnostic device) to detect the degree of under-pigmentation and thus advise you on the likelihood of repigmentation.

I bet your daughter will be as good as new.  Check it out.

Best.

Dr. Rockoff