Erythema multiforme is a skin disorder resulting from an allergic reaction. EM affects males more often than females. The rash is made of spots that are red welts, sometimes with purple or blistered areas in the center. Erythema multiforme may become noticeable with a classic skin lesion, with or without systemic (whole body) symptoms. Toxic epidermal necrolysis involves multiple large blisters (bullae) that coalesce. EM occurs more in younger patients, while SJS and TEN occur more in older persons. Erythema Multiforme is believed to involve damage to the blood vessels of the skin with subsequent damage to skin tissues. Approximately 90% of erythema multiforme cases are associated with herpes simplex or mycoplasma infections.
Erythema multiforme should be distinguished from urticaria, in which target-shaped lesions may also arise. Erythema multiforme should be distinguished from urticaria, in which target-shaped lesions may also arise. Herpes simplex infection is the most common cause in young adults and is strongly associated with recurrent EM. Systemic therapy to treat SJS used to be limited to supportive measures, such as placement in a burn unit. Good hygiene and isolation from others may be required to prevent secondary infections. Skin grafting may be helpful in cases in which large areas of the body are affected. Avoid systemic corticosteroids in minor cases. Oral rinsing with warm saline or a solution of diphenhydramine, Xylocaine, and Kaopectate for symptomatic relief.
Daily antiviral medications may be prescribed to prevent recurrences of erythema multiforme. Avoid use of systemic corticosteroids in EM. In herpes virus induced EM minor, Zovirax or Valtrex pills will help, but only if started in the first few days. A mild cortisone applied directly to the irritated skin areas, colloidal baths, and wet compresses may be helpful to facilitate the clearing of the lesions. Electrolytes and nutritional support should be started as soon as possible. Oral antihistamines ,topical corticosteroids and oral aciclovir longterm to prevent recurrences. Intensive care with support of body systems may be required. Systemic corticosteroids are controversial, and some believe they may predispose to complications.
Erythema Multiforme - Prevention and Treatment Tips
1. Good hygiene and isolation from others may be required to prevent secondary infections.
2. Skin grafting may be helpful in cases in which large areas of the body are affected.
3. Systemic therapy to treat SJS used to be limited to supportive measures.
4. Oral antihistamines Cytoxan, pooled gamma globulin or oral cyclosporin are dramatically helpful
5. Low-dose acyclovir can be effective for recurrence of HAEM
6. Electrolytes and nutritional support should be started as soon as possible.
7. Systemic corticosteroids are controversial is also useful erythema multiforme.
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