Erythema Multiforme

Dr. Ayush PandeyMBBS,PG Diploma

December 01, 2018

June 04, 2022

Erythema Multiforme
Erythema Multiforme

What is erythema multiforme?

Erythema multiforme (EM) is a type of hypersensitivity disorder due to infections or drugs. It presents with skin eruptions. EM usually occurs in children and young adults and is found to be more common in men than in women. In a study in India, the prevalence of EM skin lesions was found to be 25%-30%.

What are its main signs and symptoms?

EM occurs in two forms:

  • One type is mild and mainly causes skin and mouth sores
  • The other type is rare and severely affects other areas of the body besides the skin and mouth

Symptoms include:

The condition usually resolves in 2-4 weeks, but may recur. Recurrences are 2-3 times per year for many years after the first episode.

What are the main causes?

The exact mechanism behind this condition is unclear, but the main causative factors are Herpes simplex virus (HSV) types 1 and 2 and Mycoplasma pneumoniae. In 50% of cases, it is found to be due to drugs such as antiepileptics, sulphonamides, anti-gout medicines, pain-relieving medicines and antibiotics. In some patients, the condition may be inherited.

How is it diagnosed and treated?

EM is mostly diagnosed clinically. Doctor diagnoses the condition by analysing the type, size and colour of the rash. Skin biopsy may be ordered to rule out other conditions, but is not specific for EM. Laboratory tests may have to be done to rule out HSV infection. Differential diagnoses include skin rashes, hives, viral exanthems and other types of hypersensitivity disorders.

The first step is to treat the suspected infectious cause or stop the offending drug. Mild form of EM usually resolves in a few weeks without treatment. Topical drugs may be used for symptomatic relief, along with antiseptics, antihistamines and mouthwashes. Medicines to manage pain can be given. For flaky or blister-forming lesions and erosive lesions, moist compresses can be used. Other treatments include:

  • Antibiotics for infection
  • Steroids to control inflammation

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  1. MedlinePlus Medical Encyclopedia: US National Library of Medicine; Erythema multiforme
  2. National Organization for Rare Disorders. [Internet]. Fairfield County, Connecticut, United States; Erythema Multiforme.
  3. American Academy of Family Physicians. [Internet]. Leawood,Kansas, United States; Erythema Multiforme.
  4. Dr Amanda Oakley. [Internet]. Dermnet, Hamilton, New Zealand 1997; Erythema Multiforme.
  5. Hafsi W, Badri T. Erythema Multiforme. [Updated 2019 May 2]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-.
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