Brief Answer:
Erythema Multiforme Minor

Detailed Answer:
Hello. Thank you for writing to us

I have gone through your query in detail and I have also reviewed the Images. I can make out small target shaped lesions on wrist and elsewhere.

I suggest a possibility of Erythema Multiforme Minor (EM). EM is a hypersensitivity reaction which is usually triggered by an infection in about 90% of cases.
Herpes labialis/ cold sores is the most common cause among infections.

Clinically, EM Minor is characterized by ring Or target shaped lesions. In a well defined lesion of EM Minor, there are 3 Zones i.e central necrosis or blister (zone 1) which is surrounded by a wheal (zone 2) and a ring of erythema (zone 3).

EM Minor lesions are typically distributed over palms, dorsal hands, arms, face, legs and thighs. Oral mucosa and lips may also be involved.
Some patients may complain of itching.
EM is self limiting and treatment is with topical steroids for skin lesions and with Oral antivirals e.g acyclovir, if EM is associated or accompanied by cold sores.

Regards

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Brief Answer:
EM may be linked to underlying herpes

Detailed Answer:
Hi.

History of cold sores suggests that this episode of EM might be linked to underlying herpes. Sometimes EM may predate Or may be associated with an episode of cold sores.
It is very possible that the lesions that you presently have on nostrils and/or around lip area are also EM related, if not cold sores! (need to be confimed) as EM can affect the face as well as nostrils.
There is no permanent cure for cold sores, however, the frequency of episodes lessens with time. In those in whom epsiodes of cold sores are too frequent Or are associated with recurrent erythema multiforme, continuous suppressive treatment with acyclovir can be considered.
However, antiviral treatment has no role in Erythema Multiforme Minor that has already evolved. Suppressive antiviral therapy is only for prevention.

Regards

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