Erythema multiforme: Difference between revisions

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Image:erythema multiforme (HSV, target lesion).jpg|Erythema Multiforme (HSV, drug rxn, target lesion)  Severe = Stevens-Johnson Syndrome<ref>http://picasaweb.google.com/mcmumbi/USMLEIIImages/photo#5089143178601475426</ref>
Image:Steven_Johnsons_Syndrome.jpg|Erythema Multiforme Major
Image:Steven_Johnsons_Syndrome.jpg|Erythema Multiforme Major
Image:Erythema_multiforme.jpg|Erythema Multiforme reaction to an antibiotic
Image:Erythema_multiforme.jpg|Erythema Multiforme reaction to an antibiotic
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Revision as of 15:15, 17 August 2012

Erythema multiforme
ICD-10 L51
DiseasesDB 4450
MedlinePlus 000851
eMedicine derm/137 

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Charmaine Patel, M.D. [2]

Overview

Erythema multiforme is a skin condition of unknown etiology, but some authors suggest that the disease is mediated by deposition of immune complex (mostly IgM) in the superficial microvasculature of the skin and oral mucous membrane. It can occur due to drug exposure,as well in association with some types of infections. It varies from a mild, self-limited rash (E. multiforme minor) to a severe, life-threatening form (E. multiforme major, or Stevens-Johnson syndrome) that also involves mucous membranes.

Common Causes

E. multiforme may also be caused by drug reactions, most commonly sulfa drugs, phenytoin, barbiturates, penicillin, and allopurinol, or a host of internal ailments. The most common predisposing infection for E. multiforme is Herpes simplex, but bacterial infections (commonly Mycoplasma) and fungal diseases are also implicated.

Diagnosis

History and Symptoms

The skin form of E. multiforme, far more common than the severe form, usually presents with mildly itchy, pink-red blotches, symmetrically arranged and starting on the extremities. It often takes on the classical "target lesion" appearance, with a pink-red ring around a pale center. Resolution within 7-10 days is the norm.

Erythema multiforme target lesions
Erythema multiforme target lesions









Laboratory Findings

Laboratory findings are non-specific and can include an elevated erythrocyte sedimentation rate (ESR), elevated white blood cell count (WBC), and elevated liver enzymes.

References



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