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Erythema Multiforme - Definition, Causes, Symptoms and Treatment


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. It is associated with many infections, collagen disease, drug sensitivities, allergies, and pregnancy.

A severe form of this condition is Stevens-Johnson Syndrome. This condition can be associated with fever, muscle aches, and not feeling well. It often also affects the mouth, eyes and other moist surfaces.

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. As the skin lesions age they often look like small targets with purple to dusky centers surrounded by red rings.

The disease is due to a hypersensitive reaction to one of a number of immunologic stimuli including drugs and infectious agents.

Causes of Erythema Multiforme:

Some important causes of erthema multiforme includes:-

  • The most common causes of erythema multiforme are Mycoplasma pneumonia, cold sores, herpes of the genitals, and as a reaction to medication (sulfa drugs).
  • The chest infection i.e. Mycoplasma pneumonia, may also result in erythema multiforme.
  • Erythema multiforme is not contagious.
  • The damage to the blood vessels of the skin with subsequent damage to skin tissues, cause erythema multiforme.
  • It is mainly induced by allergic reactions to drugs, such as valdecoxib , penicillins , barbiturate , sulfas , phenytoin , lamotrigine and evirapine.
  • Certain bacterial infections, are also responsible in the formation of erythema multiforme.
  • Adverse reaction to vaccinations, may also lead to the condition of erythema multiforme.
  • Some people have recurrent episodes of erythema multiforme, usually due to cold sores or herpes infection.
  • The erythema multiforme, may be caused by some viral infections such as herpes simplex virus , influenza , mumps , cat-scratch fever , histoplasmosis and Epstein-Barr virus.

Symptoms of Erythema Multiforme:

The possible symptoms of erythema multiforme includes:-

  • There will be multiple skin lesions that appear as nodule , papule , or macule. These are located on the legs, arms, palms, hands, or feet
  • If your eyes are affected, you may become sensitive to light and notice blurring of your vision.
  • Itching of the skin may be present
  • The tiredness, may be seen in the patients of erythema multiforme.
  • Mouth sores, may be seen in patients of erythema multiforme.
  • There may be the occurance of throat rashes and blisters.
  • You may have the feeling of illness.
  • The arthritis problem is common during erythema multiforme.
  • You may have the feeling of eye pain.
  • The blisters and rashes, may be found around anus.
  • If your erythema multiforme is more severe, you may have a fever and a headache, and feel unwell for a few days before the rash appears.

Treatments of Erythema Multiforme:

The effective treatments for erythema multiforme are as:-

  • If the EM keeps recurring, a continuous low dose of Zovirax or Valtrex will prevent it.
  • Over-the-counter medications (such as acetaminophen) to reduce fever and discomfort
  • The intravenous Cytoxan , pooled gamma globulin or oral cyclosporin are very effective in the treatment of erythema multiforme.dramatically helpful.
  • An oral steroids, such as prednisone, also is still useful in some cases.
  • Skin grafting may be helpful in cases in which large areas of the body are affected.
  • If it is caused by herpes virus, then daily antiviral medications may be prescribed to prevent recurrences of erythema multiforme.
  • Medications such as antihistamines to control itching
  • cool compresses, are very helpful in the treatment of EM. Apply it tot he skin lesions.
  • If itching is bothersome, standard treatments may be used. Corticosteroids given by mouth may be helpful.
  • If painful mouth blisters make eating difficult, a topical anesthetic, such as lidocaine Some Trade Names XYLOCAINE may be applied.
  • Certain antibiotics, may be suitable to get recover from erythema multiforme.