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Erythema multiforme

The classic cause, an acute hypersensitivity reaction with characteristic 'target' or iris lesions with three distinct concentric zones.

Insect bite reaction

A hypersensitivity reaction to an insect bite can sometimes form an atypical target lesion with a central punctum.

Secondary syphilis

The 'great imitator,' which can rarely present with targetoid lesions, especially on the palms and soles.

Serum sickness

A systemic immune complex reaction that can cause fever, arthritis, and an urticarial or morbilliform rash that may have targetoid features.

Stevens-Johnson syndrome

A severe drug reaction characterized by widespread dusky red macules and 'atypical target lesions' which have only two zones and a central blister or necrosis.

Toxic epidermal necrolysis

The most severe drug reaction, which may begin with atypical target lesions before progressing to widespread epidermal detachment.

Urticaria

Annular urticarial wheals can have central clearing and resemble target lesions, but they are transient and resolve within 24 hours.

Vasculitis

Urticarial vasculitis can present with targetoid wheals that last longer than 24 hours and leave behind purpura.

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