Table 2.

Differential diagnosis of SSLR in children (adapted from references [12,19,20])

	Rash	Facial edema/ itchiness	Fever	Joint involvement	Mucous membrane involvement/ ulceration	Other systemic features
SSLR	Fixed erythematous annular/polycyclic skin lesions with central clearing and or purplish discoloration (lesions resolve 5–10 days)	Occasional	Common	Always Edema, redness, severe joint pain and inability to walk	No	Malaise and irritability. Poor response to antihistamines
Urticaria	Papular, pruritic patches (hives) Migratory (hives resolve < 24 h)	Common	Seldom (related to underlying viral illness)	No	No	Mild malaise associated with underlying viral illness. Improves with antihistamines
Erythema Multiforme	Symmetric, involving palms, soles, face, oral mucosa. Typical target lesions. Non-migratory. (lesions resolve after several days and may leave postinflammatory hyperpigmentation)	Uncommon	Occasional	Uncommon	Yes	Malaise +/- Cough, respiratory symptoms
Urticaria Multiforme	Transient onset of annular and polycyclic lesions with dusky/purplish center (lesions resolve 24–48 h)	Common	Occasional low grade	Acral edema without joint inflammation	Oral edema but no erosions or blisters	Minimal systemic affection Improves with antihistamines