Erythema Multiforme – Causes, Symptoms & Treatment

March 19 22:12 2019 Print This Article

Erythema multiforme is an acute, self-limiting, inflammatory skin eruption. It has been so named because of macules, papules, or subdermal vesicles presenting a multiform appearance. This variation has led to EM being divided into two overlapping subgroups (EM minor and Stevens-Johnson syndrome). These are different faces of the same disease. EM is relatively common problem for a dermatologist.

Half the cases are in young people (under 20). It rare both under the age of 3 and over the age of 50. Males are slightly more affected than females and there is no racial predilection. One third of EM sufferers will have a recurrence of the disease. Erythema multiforme often starts as a red rash on the palms, soles, and back of the hands. It can spread to the trunk, face, and mouth in severe cases. Some people only have erythema multiforme in the mouth. As the skin lesions age they often look like small targets with purple to dusky centers surrounded by red rings. The condition can be associated with fever, muscle aches, and not feeling well.

Erythemam multiforme is the skin problem which occurs as the reaction due to infection or medication and is discovered by Ferdinand von Hebra in 1866. In this disease a red rash is obtain on the skin which is the sequence of the spots. Erythema multiforme is a common skin disorder consisting of target-like circular lesions: red center, pale ring, and dark red outer ring. These lesions appear suddenly on the legs, arms, palms, hands, feet, and inside the mouth. Erythema multiforme minor is the most frequent form and is generally mild.

Erythema multiforme major, while rare, can be life-threatening. This severe form of the disorder usually causes target lesions with painful blisters at their center, which tend to appear on the trunk, eyes, inside the mouth, and genitals. It is also called Stevens-Johnson syndrome. 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.

Causes of Erythema Multiforme

Erythema multiforme is caused by hypersensitivity reaction of the blood vessels in the skin.  In the minor form of erythema multiforme this is most commonly caused by the herpes virus (cold sore virus).   Erythema multiforme has many causes, most commonly are drugs. Penicillin, sulfonamides, certain epilepsy drugs, aspirin, and acetaminophen are the most likely medication-induced causes. Erythema multiforme can also be caused by certain diseases.

Find common causes and risk factors of Erythema Multiforme:

  • Use of cocaine is also the cause of erythema multiforme.
  • Different types of infections like parasitic, fungal, viral, bacterial.
  • Erythema multiforme is not contagious.
  • Erythema multiforme is a cause of allergic reactions of medications, infections, or illness.
  • Some people have recurrent episodes of erythema multiforme, usually due to cold sores or herpes infection.

Signs and Symptoms of Erythema Multiforme

Sign and symptoms may include the following:

  • Fatigue.
  • Joint pains.
  • Mouth sores.
  • Itching.
  • General ill feeling.
  • Cold sores.
  • Fever.
  • Vision problems.
  • Burning, painful, or itchy eyes.

Treatment for Erythema Multiforme

Erythema multiforme is inadvertently treated when the causative agent, whether it be a drug or a disease, is treated. In severe cases, cortisone-like medication is often used along with general supportive measures and prevention of infection.

Treatment may include:

  • Use of hydrogen peroxide for mouth washing which helps to destroy the crust.
  • Antiviral drug like acyclovir may be used to prevent from erythema multiforme.
  • Corticosteroids
  • Antibiotics
  • Over-the-counter medications (such as acetaminophen) to reduce fever and discomfort
  • Oral antihistamines treatment is used to control itching.
  • Some patients applied cortisone directly to the infected area which helps in clearing the spots.
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