erythema multiforme

Hello,

I am a pediatrician. I have a patient with erythema multiforme, who is 1 year old.  He also has bad fevers, scleral injection.  My differential diagnosis is:
1. kawasaki
2. drug reaction
3. viral reaction
4. mycoplasma

What is missing?  Anyone?

[teapot16]

Hello, I have a son who first had erythema multiforme at 12 months and now has it again at 20 months.  I took him to Texas Childrens Emergency Room both times.

The first time he had no fever and had no itching or any other issues just the rash and swollen face.  It took about 10 days on steroids to go away.  He was so covered in the rash that they brought in several doctors and used him as the example to show off.

Now he has it again, neither time did they do skin lesion biopsy which I've read about so I made him an appointment with a dermatologist but hope it's not too far out that he will be better by then.

He is absolutely miserable this time with a low 100.1 fever and joint soreness as well as swollen hands, feet, and face.  They ran urine tests to make sure his kidneys were working properly this trip to the ER.  Both times they said it was from a viral reaction.  They didn't seem to think it was from the same virus like herpes simplex.  He has on his scalp and on his palms and bottom of his feet.  They told us just to give him Benadryl, Tylenol, and Motrin.  I bought aloe spray with lidocaine in it to help with some of the itching, but it doesn't penetrate the bottom of his feet.  It seems that nothing but time can help!

Just by looking at the rash they determined it wasn't Kawasaki and since he wasn't on any drugs they said it must be viral.

We have a lot of concerns, we were not expecting him to get it again.  Will he get it for the rest of his life?  Will it continue to get worse? Is there anything we can do to prevent it? Etc.

The new case came a day after hours in the sun.  He had SPF50 on and had no tan or burn but the rash stared the next day.  He had what was diagnosed as viral pink eye the week before and diarhea (diarrhea) for a day during the week before.

I stay at home with him and his 5 month old brother who hasn't had an illness yet.  Knock on wood.  He's not in any daycare or preschool and other than the grocery store and occasional outing we stay home most of the time.  What can I do to prevent him from this miserable rash again?

Both times their first questions were if he was on any drugs, if we have traveled out of the state.  He's not on any drugs and hasn't been out of the state.  When they sent us home they asked us to watch his eyes and mouth for sores and his fever spiking because that would be a sign of it worsening.

What have you learned? Is there anything you can share?

Please let me know!