DEAR DR. DONOHUE: Our 26-year-old, normally healthy son has recently recovered from erythema multiforme minor. The dermatologist said it was a violent reaction to strep bacterium. He had large blisters over most of his body, even the palms of his hands and soles of his feet. He suffered extreme itching and pain. The affected skin peeled off and left raw areas.

Please comment on this disorder and the likelihood that it may return. — D.S.

ANSWER: Erythema (Greek for “red skin”) multiforme (“many different shapes and sizes”) consists of circles that look somewhat like bull’s-eyes on targets. It’s an outbreak engineered by a reaction that’s generated by antibodies, like an allergy. The circles vary in shape and size and have a red perimeter with a dusky, violet center. Blisters may appear on them. Few rashes appear on the palms and soles. This is one of them.

Erythema multiforme minor (which is anything but a minor illness) often is traced to a virus infection. Erythema multiforme major is caused by medicines, viruses and bacteria.

Yes, either of these two illnesses can recur. If a virus has been determined to be the cause and if recurrences are many, then a daily dose of antiviral medicines can prevent such recurrences. If a medicine was the cause, then avoiding that particular medicine prevents repeated attacks.

As bad as your son’s illness was, the major variety is worse, and two other related diseases, Stevens-Johnson syndrome and toxic epidermal necrosis, are even more serious.

TO READERS: Vertigo (dizziness) is a common complaint of older people. The booklet on that topic explains its causes and treatments. To order a copy, write: Dr. Donohue — No. 801, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: This is my third letter. I am writing regarding a stress test.

I am 87 years old and was told by my doctor to take a stress test again. Since I had one about a year ago, which I passed, I am seeking your advice on whether this test is necessary at my age. Please answer this letter. — J.M.

ANSWER: I apologize for the delay in answering your letters. Let me explain why. I hesitated to interfere with your doctor’s wish to have you take another stress test so soon after one that you passed. Your doctor knows you and your heart much better than I do.

I would ask the doctor what are the reasons for insisting upon another stress test so soon after the one you had less than a year ago. If his answer is reasonable, I would take the test.

If the answer sounds unreasonable, I would get another doctor.

There has to be a good reason for requesting another such test in such a short period of time.

DEAR DR. DONOHUE: When is the best time to take calcium and with any particular foods? Does it matter where calcium is purchased? — G.R.

ANSWER: Calcium carbonate, probably the most-used kind of calcium, needs stomach acid for absorption. It’s best, therefore, to take it during or after meals, when stomach acid production is at its highest. Calcium citrate can be taken at any time.

No more than 500 mg of calcium should be taken at one time. Only that amount is absorbed well in one dose.

It doesn’t matter where you buy your calcium.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.

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