Multiform Erythema

Multiform Erythema

What Is Erythema Multiforme

What is erythema multiforme?

Erythema multiforme, also known as polymorphous exudative erythema, is an acute inflammatory skin disease with a complex etiology. It is currently considered related to allergic reaction and mainly treated with drugs.

Rash has a variety of forms, erythema, papules, wheals, blisters, etc.

The characteristic skin lesions were target lesions, namely, iris-like rash, with varying degrees of mucosal damage, and a few with visceral damage. It is self-limited, and the skin lesion can resolve and easily relapse after about 2–4 weeks.

Erythema multiforme is good hair in which person?

The disease occurs frequently in spring and autumn, and is slightly more in men than women, with the incidence rate at the age of 10–30 years old being the highest. A special type of cold erythema multiforme, occurs every year in the cold season.


What Is The Cause Of Erythema Multiforme

What are the causes of erythema multiforme commonly?

Erythema multiforme is generally considered to be a skin disease caused by an allergic reaction, but the application of allergic reactions to explain some of these types may be controversial.

  • Infection was that main cause, with herpes simplex virus and mycoplasma pneumoniae bee the two most common causes of infection. Other pathogens such as bacteria, rickettsia infection can also cause.

  • The other major disease is drug eruption caused by sulfonamides and non-steroidal drugs such as aspirin and antiepileptic drugs.

  • Some contact substances such as capsaicin, formaldehyde, primrose, eat bad food fish, eggs, tattoos, some physical factors such as cold sun, radiation can also induce erythema multiforme.

  • It may also be one of the clinical manifestations of some visceral diseases such as connective tissue disease, vasculitis, and leukemia.


What Symptom Does Erythema Multiforme Have

What symptom does erythema multiforme often appear?

  • It usually starts in a rather urgent manner, with prodromal symptoms including low grade fever, headache, limb fatigue, joint and muscle soreness, tonsillitis and respiratory tract infection. Non-specific upper respiratory tract infection was the typical manifestation of the disease history at the beginning.

  • The rash develops within 24 hours. Skin lesions show pleomorphism, erythema, maculopapules, blisters, bullae, purple spots with wheals, etc., but maculopapules and erythema are the most common. The rash is likely to occur in the face, neck and distal parts of four limbs, which is symmetrically distributed. The mucosa of mouth and eyes often shows swelling and ulceration.

  • Rash characteristic is typical, erythema size is like lentil or fingernail, color is bright red, dark red or purplish red in the middle, some erythema center can resolve, form annulus, or appear among overlapping blister, like target or iris, namely its characteristic target damage or iris-shaped rash, have important sense to diagnose.

  • The affected area often has pruritus or mild pain and burning sensation. Severe cases have systemic symptoms such as fever.

What are the clinical types of erythema multiforme?

Erythema multiforme has three clinical types, including

  • Erythema-papule type;
  • Localized vesicular (vesicular-bullous);
  • Severe type (SJS, erosive erythema multiform in Stevens-Johnson syndrome, which is still controversial at present).

What are the characteristics of erythema-papule type erythema multiforme?

  • Erythema-papule type is the most common type of erythema multiforme, with mild symptoms and easy recurrence, and is mostly related to herpes simplex virus infection.

  • The rash was mainly composed of erythema and papule, which were distributed on the extensor side of the extremity. Typical lesions are edematous erythema, which in its severity can present as blisters, with a target-or iris-like appearance. Mucosal damage is mild and is often confined to the oral mucosa.

  • It usually disappears after 2–4 weeks, with pigmentation.

What are the characteristics of localized vesicular erythema multiforme?

  • Localized vesicular, also called vesicular-bullous, is between mild and severe. Rash is given priority to with blisters, erythema with blisters in the center or erythema for blisters around, rash number is not much, is limited to the extremity parts, whole body skin mucosa can be damaged. It can be accompanied by systemic symptoms.

What are the characteristics of severe erythema multiforme?

SJS, a severe erosive erythema multiform (Stevens-Johnson syndrome), has a rapid onset, severe systemic symptoms and a mortality rate of 5%–15%, which is a serious systemic disease.

  • Prodromal symptoms occur before the onset of disease, in which there may be fever, sore throat, intolerance of cold, headache and general malaise. The erythema, with a large number, is mainly distributed in the four limbs and often spreads to the trunk. Most of them belong to the typical target-shaped lesions, including fever, skin lesion all over the body and mucosal lesion in multiple parts.

  • The damage to the skin mucosa is sudden and acute, and most severe in 2–4 weeks, with no pruritus for typical skin damage. Among them:

    • Oral and nasal mucosa ulceration, gray pseudomembrane on the surface, and pain; Oral and nasal mucosa ulceration, gray pseudomembrane on the surface, and pain;

    • Conjunctival congestion, exudation, keratitis, moderate to severe keratitis or blindness of the whole eye can be caused, and the incidence rate is 3%–10%;

    • Swelling and erosion of vulva and perianal mucosa;

    • Respiratory tract and digestive tract mucosa involvement causes inflammation, hemorrhage, even respiratory failure and esophageal stenosis.

    • It may be complicated with necrotizing pancreatitis, liver and kidney function impairment, and septicemia caused by secondary infection.


How To Check For Erythema Multiforme

In which department should erythema multiforme see a doctor?

You should see a dermatologist. Severe and severe erythema multiforme ulceration and complications in the eyes, lips, esophagus and respiratory tract should be consulted by various specialists.

How should erythema multiforme be diagnosed?

The disease is mainly classified and diagnosed according to clinical symptoms and special rash phenotype. Emphasis should be placed on differentiation from other skin diseases with similar phenotypes.

The skin lesion of this disease shows pleomorphism, with typical target-shaped injury. The rash frequently occurs in the face and neck, and distal limbs, and is symmetrically distributed. The mucosa of mouth and eye are often involved. Severe cases have systemic symptoms such as fever. It is preceded by prodromal symptoms of nonspecific respiratory infections.

How should erythema multiforme differentiate diagnosis?

Erythema multiforme needs to be distinguished from chilblain and urticaria.

  • Chilblain: It usually presented as dark purple edematous patches with unclear boundaries, which were more likely to occur in the ears and prominent parts of hands and feet, and rarely in the mouth parts of palms and soles.

  • Urticaria: The hair has no definite place, and it occurs and disappears rapidly. The rash shape is a single wheal, generally there is no blister, and the patient feels intense itching.


How To Prevent Erythema Multiforme

How to prevent erythema multiforme

If it is drug-induced erythema multiforme, stop using the suspected sensitizing drugs, drink more water, rule out the sensitizing drugs as soon as possible, remember the sensitizing drugs, and avoid re-use in the future. Take the medicine as ordered.


How Does Erythema Multiforme Treat

What is the treatment principle of erythema multiforme?

Treatment varied according to the type, severity and location, mainly pharmacological treatment. If the etiology is clear, the primary cause should be eliminated. Therapeutic drugs can be divided into internal medicine and external medicine.

What is the principle with medicaments treatment inside polymorphous erythema?

  • For mild cases, oral antihistamines such as diphenhydramine, chlorpheniramine and cyproheptadine were routinely used.

  • Adequate glucocorticoids should be given to severe patients as soon as possible;

  • Supportive therapies to maintain water and electrolyte balance and ensure calorie, protein and vitamin needs.

  • Antibiotics should be used if the disease is found to be associated with an infectious focus.

What is the principle of polymorphous erythema external therapy?

  • For skin lesions available cleaning, protection, antipruritic, mild anti-inflammatory agents, such as vegetable oil, calamine lotion, zinc oxide oil, silicone oil cream, glucocorticoid ointment, etc.

  • Use gargle for oral lesions to keep the mouth clean.

  • Eye mucosa is damaged, requiring eye care to prevent adhesion and blindness, and other appropriate symptomatic treatment.

What is the prognosis of erythema multiforme?

  • The disease is self-limiting and the skin lesion can resolve in about 2–4 weeks unless secondary infection occurs. Most patients have no sequelae after recovery, but they are prone to relapse.

  • Secondary infection determines the prognosis, and severe patients may suffer from respiratory failure, renal failure, and blindness.

  • 15% of patients die from serious complications.


What Should The Patient Of Erythema Multiforme Notice In Life

What does erythema multiforme need to notice on food?

  • Diet spicy excitant food, fish and shrimp, crab, garlic, leek, etc.

  • A moderate amount of vitamin C supplementation, more water, less food and more meals, eating rich nutrition, high protein, high vitamins, low salt, less to stimulate the flow of easily digested food, such as milk, fruit juice, rice soup, etc. The food temperature was controlled at about 37 C to avoid irritation to mouth and lips due to excessive temperature.

What should the patient of erythema multiforme notice when bathing?

  • Keep the skin clean, appropriate uses the warm water to take a bath, avoids uses the hot water to scald, forbids the alkaline big soap, the body soap to take a bath.

  • Do not scratch the skin to prevent secondary infection.

  • When the itching is obvious, the itching-relieving ointment can be applied locally or the skin can be gently pressed and slapped by hands to reduce the itching sensation.

  • Change your underwear frequently.

What should patients with erythema multiforme notice?

  • Strengthen physical exercise, improve the body immunity, adjust the mood cheerful;

  • Cold pleomorphic erythema pay attention to keep warm cold;

  • • protective isolation;

  • After discharge, patients should take drugs correctly in strict accordance with doctor's advice and keep in touch with medical staff at any time so as to get timely guidance.

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