RT Journal
A1 Myers SR, Lavelle J
T1 PIcture of the month—quiz case
JF Archives of Pediatrics & Adolescent Medicine
JO Archives of Pediatrics & Adolescent Medicine
YR 2009
FD December 1
VO 163
IS 12
SP 1157
OP 1157
DO 10.1001/archpediatrics.2009.221-a
UL http://dx.doi.org/10.1001/archpediatrics.2009.221-a
AB 
A previously healthy, 10-year-old boy presented with 5 days of fever and malaise. He also complained of cough, shortness of breath, sore throat, and myalgias. Three days earlier, he developed the erythematous, annular, and polycyclic rash pictured (Figure 1and Figure 2). The lesions were blanching and coalesced in some areas; a subset of the lesions had dusky central zones. The rash waxed and waned and lesions appeared in different areas of the body at different times. When the rash was intense, he noticed periorbital and perioral edema. The erythematous macules faded leaving no residual skin changes. There was some improvement with diphenhydramine treatment.