About erythema multiforme

What is erythema multiforme?

Erythema multiforme (EM) is the name applied to a group of hypersensitivity disorders, affecting mostly children and young adults, and characterized by symmetric red, patchy lesions, primarily on the arms and legs. The cause is unknown, but EM frequently occurs in association with herpes simplex virus, suggesting an immunologic process initiated by the virus. In half of the cases, the triggering agents appear to be medications, including anticonvulsants, sulfonamides, nonsteroidal anti-inflammatory drugs, and other antibiotics. In addition, some cases appear to be associated with infectious organisms such as Mycoplasma pneumoniae and many viral agents.

Erythema multiforme is the mildest of three skin disorders that are often discussed in relation to each other. It is generally the mildest of the three. More severe is Stevens-Johnson syndrome. The most severe of the three is toxic epidermal necrolysis (TEN).

What are the symptoms for erythema multiforme?

Tops of feet symptom was found in the erythema multiforme condition

The erythema multiforme rash

The EM Rash can consist of dozens of target-shaped (bull’s-eye pattern) lesions that develop over a 24-hour period. These Lesions can start on the backs of hands and tops of feet before spreading to the trunk. They may also develop on the face and neck. The arms may be more affected than the legs. These Lesions can be concentrated on the elbows and knees.

Erythema multiforme minor

In minor cases of EM, there are Lesions covering the affected area. The Rash will affect both sides of the body. For example, if it’s on one leg, it will also affect the other leg.

If you have EM minor, you may have no symptoms other than feeling like the Rash is Itching or Burning and perhaps a low fever.

Erythema multiforme major

In cases of EM major, there can be additional symptoms, such as:

  • fatigue
  • joint ache
  • a brownish color to the Rash once it fades

EM major lesions can also seriously affect any of the body’s mucous membranes, most often the lips and interior of the cheeks. It can also affect the:

  • bottom of the mouth, palate, and gums
  • eyes
  • genitals and anus
  • trachea (breathing tube)
  • digestive tract

Lesions in these areas may cause Swelling and Redness with blisters. The Blisters also break, leaving painful, large, irregularly shaped ulcers covered with a whitish membrane. When the lips are affected, they’re swollen and covered with a bleeding crust. There can be difficulty speaking and swallowing because of pain.

What are the causes for erythema multiforme?

Erythema multiforme is associated with the virus that causes cold sores (herpes simplex virus). Doctors also believe that many cases of erythema multiforme occur when other infections stimulate the body’s immune system to attack skin cells. Certain medications can also cause someone to develop erythema multiforme:

If, while using any of these drugs, you notice an EM rash starting, tell your doctor. Don’t stop taking medication without consulting your doctor.

Getting immunized against diseases such tetanus-diphtheria-acellular pertussis (Tdap) or hepatitis B may also cause a person to develop EM. This is rare and the low risk does not usually warrant remaining unvaccinated. Talk to your doctor if you have concerns about vaccine side effects.

Unfortunately, doctors may not always know what caused your rash to develop.

What are the treatments for erythema multiforme?

In both major and minor forms of EM, the symptoms are treated using:

  • antihistamines
  • pain relievers
  • soothing ointments
  • a saline mouthwash or one containing antihistamines, pain relievers, and Kaopectate
  • topical steroids

In severe cases, careful wound care and Burrow or Domeboro solution dressings could be necessary. Using a liquid antiseptic such as 0.05 percent chlorhexidine when bathing will help prevent infection from other bacteria or viruses. You can also use a gauze dressing for sensitive areas like the genitals. In all cases, your doctor will try to discover what’s causing the rash to decide on the best way to resolve it.

If it’s an infection

If an infection is the cause, then the appropriate treatment will depend on the results of cultures or blood tests. If herpes simplex virus is the cause, your doctor can only treat it to prevent future outbreaks after the condition resolves.

If it’s due to medication

Your doctor may stop all drugs as a first step to discovering which could be causing the symptoms.

In the worst cases of erythema multiforme major, hospital staff may have to treat respiratory problems and dehydration or edema.

What are the risk factors for erythema multiforme?

Taking certain medications can cause someone to develop erythema multiforme:

If, while using any of these drugs, you notice an EM rash starting, tell your doctor. Don’t stop taking medication without consulting your doctor.

Is there a cure/medications for erythema multiforme?

The majority of Erythema Multiforme infections, according to doctors, are thought to be caused by other infections that trigger the body's immune system to assault skin cells. Unfortunately, it's not always clear to doctors what brought on your rash.

  • On the basis of the patient's medical history and physical examination, Erythema Multiforme is clinically diagnosed. It is imperative to enquire about recent medication use as well as symptoms of infection (such HSV or M. pneumoniae).
  • The majority of Erythema Multiforme symptoms don't need any additional diagnostic procedures. Skin biopsies and laboratory tests, however, may be useful in uncertain cases to rule out alternative diseases.
  • Antiseptic mouthwashes, anaesthetic, and topical treatments for bullous lesions are the main components. Ophthalmologists are in charge of managing ocular involvement. Vaseline applied to the lips and vitamin A ointment applied to the eyes both aid in the healing process.
  • When a cause is discovered, etiological treatment must start (or sometimes probable). Without even waiting for the results of the bacteriological tests, treatment with azithromycin for three days is warranted in cases of Mycoplasma pneumoniae infection, especially if there is a cough or lung radiological abnormalities. If herpes is suspected, some advise treating it with aciclovir or valaciclovir, though.

Target-shaped (bull’s-eye pattern) lesions appear on the backs of hands, tops of feet, face and neck,Fatigue and joint ache in severe cases
Red spots and blisters appear on the tops of hands and forearms
Antihistamines,Pain relievers,Soothing ointments
a saline mouthwash or one containing antihistamines,Pain relievers, and Kaopectate,Topical steroids

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