What is Erythema multiforme?

Erythema multiforme is a common dermatological condition of idiopathic origin, potentially mediated by the accumulation of immune complex in the microvasculature surface of the skin and mucosa. It is a severe, self-limiting inflammatory skin condition under type IV hypersensitivity reaction triggered by the exposure to certain medications, contagion and other factors. In general, it affects the young population.

Symptoms

Erythema multiforme minor

Of the two types, EM minor is the less serious and accounts for 80% of Erythema multiforme cases. The rash comes out over a few days somewhat expanding to around 2 cm. but in some patients more than a few crops go after each other in single attack. Slight burning or mild itch may be existing but becomes most intense over the back of the hands and feet. Classically, the rash appears as bull’s eye shaped circles on the palms arranged symmetrically and lasts for 7 to 14 days and then resolves leaving a remaining brown colored discoloration. There is an involvement of the oral mucosa for 70% of the cases. Oral lesions in the lips, palate, and gums are common. The eyes are affected. There are red conjunctivae and eye swelling and excessive tearing. There are also excruciating erosions on the genitals.

Stevens Johnson syndrome

In this situation, there is larger injury. Together with the erythematous eruption, there are a few significant hemorrhagic blisters present. There are extensive blood blisters predominant on the torso and face.

Causes

The Pathophysiology of Erythema multiforme is not yet fully implicated but it appears that there is a taking part of the cell-mediated hypersensitivity reaction by the immune system that can be elicited by variety of stimuli, specifically bacteria, viruses and chemicals.

As revealed in a current global future analysis, the most important cause of Erythema multiforme is Herpes simplex virus, but bacterial, parasitic and fungal infections are also correlated. In the case of Stevens-Johnson syndrome and toxic epidermal necrolysis, it looks to play a smaller role. Drugs were found to be a more universal trigger for these cases. For Erythema Multiforme minor and major, the principal risk factor is history of herpes infection or recurrent case of herpes.

Treatment

The treatment starts with identifying the activating factor and removing it, however, this is not all the time achievable. If drug is the culprit, it must be discontinued as soon as possible. If the cause is infection, it must then be properly treated following the performance of diagnostic tests.

Erythema multiforme minor is typically without a clinical symptom therefore requires no treatment, as the lesions are self-limiting and will disappear within a month. If EM minor is herpes virus induced, Zovirax is useful.

Mild cases of Erythema multiforme require only symptomatic management. Give analgesics as needed, skin care; topical steroids, and soothing mouthwash and gargles. Aggressive observation and fluids and electrolytes replacement are of dominant significance.



No responses yet

Leave a Reply

Erythema Multiforme Pictures

erythema multiforme pictures erythema multiforme pictures erythema multiforme pictures erythema multiforme pictures erythema multiforme pictures erythema multiforme pictures