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erythematic Multiforme

This reaction pattern of blood vessels in the dermis with secondary epidcrmal changes is exhibited clinically as characteristic erythematous iris-shaped papules & vesicolobullous lesions typically involving the extremities (especially the palms & soles) & till the mucous membranes. erythematic multiforme can be minor or more severe. The more severe form is also known as Stevens-Johnson syndrome. Severe reactions can involve the skin, lungs, kidneys, eyes, & other areas.

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 & over the age of

reason of erythematic multiforme

The cause of erythematic multiforme often remains unknown. Possible reason include: Viral infection (especially herpes simplex ) Mycoplasma pneumonia (a chest infection) Medicines (especially those containing sulfa) Immunizations

Signs & symptoms of erythematic multiforme

• Multiple skin lesions:
  • With sudden onset, which may recur
  • That may spread
  • Located on the legs, arms, palms, hands, or feet
  • May involve the face or lips
  • Trunk is usually not involved
  • Usually symmetrical
• Itching of the skin may be present
• Fever
• Dry eyes
• General ill feeling

On the skin, a wide variety of irregular red macular, papular & vesicular lesions may occur, either separately or in combination. A unique lesion, the target or bull's-eye lesion appears as concentric rings of affected skin interspersed with rings of clinically normal skin, often with a bullous lesion at the center.

Diagnosis

The diagnosis is primarily based on the appearance of the skin lesion & its typical symmetrical distribution, especially if there is a history of risk factors or associated diseases.

Treatment of erythematic multiforme

Treatment of erythematic multiforme begins with identification & removal of the trigger factor, however that is not always possible. EM minor is typically asymptomatic & therefore needs no treatment, as the lesions will clear up by themselves within 2-4 weeks. In herpes virus induced EM minor, Zovirax or Valtrex pills will help, but only if started in the first few days. If the EM keeps recurring, a continuous low dose of Zovirax or Valtrex will prevent it.

Corticosteroids In severely ill patients temic corticosteroids are usually given (prednisone 50 to 80 mg/d in divided doses, quickly tapered), but their effectiveness has not beeen established by controlled studies.

Most cases of erythematic multiforme completely recover. There may be dark marks for a few months when the patches clear up. Sometimes, the condition recurs, particularly if the cold sore virus was the cause. If it happens several times a year, continuous aciclovir may prevent it.

prohibition of erythematic multiforme

• Good hygiene & isolation from others may be required to prevent secondary infections .
• Control of herpes simplex oral acyclovir may prevent development current erythematic multiforme.