Erythema multiforme em is an acute, selflimited, inflammatory cutaneous disorder caused by infection or drugs that is characterized by bulls eye lesions, blisters, and erythematous plaques on the skin fitzpatrick and bernhard 1987. The erythema multiforme rash often goes away in 1 to 2 weeks, but can last as long as 4 weeks. 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. Erythema multiforme definition of erythema multiforme by. At first the spots are small, round, slightly raised red areas, some of which turn into the target lesions described above. Erythema multiforme minor typically affects only one mucosa and can be associated with symmetrical target skin. There is also a rare but more severe type, erythema multiforme major, which has similar skin features to em minor, but additionally there is involvement of one or. Two cases of erythema multiforme secondary to furosemide have been reported in the past. Erythema exsudativum multiforme wissen fur mediziner amboss. Erythema multiforme minor em minor typical targets or raised, edematous papules distributed acrally.
Erythema multiforme for parents nemours kidshealth. Final diagnosis of herpes associated erythema multiforme was given. Use of the terminology em minor and em major is a reasonable approach to separating the classical mild cutaneous. However, since that time, erythema multiforme major has been most commonly referred to as stevensjohnson syndrome. A study was conducted in denver to assess the potential role of hsv infection in the pathogenesis of em minor in children where em skin lesions.
Em minor, a mild allergic reaction, occurs most commonly. Erythema multiforme major em major typical targets or raised, edematous papules distributed acrally with involvement of one or more mucous membranes. Polycyclic target lesions with alternating rings of erythema and dusky desquamation on the arm. It appears as a symmetrical rash and may include the mucous membrane lesions. Viral skin diseases picture of erythema multiforme minor erythema multiforme em minor is a bullseye rash with alternating rings of red erythema and flaky skin desquamation. Target lesions vesiculobullous disorder download this article as. Erythema multiforme minor mild if you have the mild form of em, you may feel perfectly well but just have an uncomfortable rash.
Erythema multiforme em is an acute, benign skin condition with a sudden onset that usually occurs due to medications, infections, illnesses, or for unknown reasons. Erythema multiforme rashes are usually located on the extremities, and rarely may involve the mucous membranes. Em with mucosal involvement is known as erythema multiforme major, and without mucosal disease it is referred to as erythema multiforme minor. Episodic angioedema with eosinophilia hereditary angioedema. Description erythema multiforme appears on the skin and the mucous membranes the lining of the mouth, digestive tract, vagina, and other organs. Em has been chiefly divided into two main forms em minor and em major. Erythema multiforme minor, erythema multiforme major. Oral erythema multiforme em is considered as a third category of em other than em minor and major. Treatment of erythema multiforme is a common skin disorder consisting of targetlike circular lesions. Erythema multiforme is usually a reaction of the skin and mucous membranes that occurs suddenly. Erythema multiforme is caused mostly because of virus herpes simplex virus 12 or rarely dt drugs sulfonamides mc and internal malignancies q. Erythema multiforme em is a skin condition of unknown cause. In 1950, thomas suggested the division of erythema multiforme into two forms. Erythema multiforme is a rare disorder that affects slightly more males than females.
Minor erythema multiforme case report medcrave online. In half of the cases, the triggering agents appear to be medications, including anticonvulsants. Erythema multiforme minor doctor answers on healthcaremagic. Erythema multiforme minor of the hands note the blanching centers of the lesion. Erythema multiforme pictures, treatment, causes, symptom. Etiopathogenesis of erythema multiforme juniper publishers. Definition erythema multiforme is a skin disease that causes lesions and redness around the lesions. This means it usually resolves on its own without treatment.
Clinical features include a rash of varied appearance, beginning as macules and papules, which evolve into characteristic. It doesnt cause a scar, but in some kids might leave darker spots on the skin for a few months. Em minor typically affects no more than one mucosa, is. I developed a full body rash which the dermatologist called erythema multiforme. Pdf erythema multiforme em is an extremely rare condition in infancy. What is erythema multiforme erythema multiforme is a hypersensitivity reaction usually triggered by infections, most commonly herpes simplex virus hsv. Erythema multiforme, stevensjohnson syndrome and toxic.
Erythema multiforme is a reactive mucocutaneous disorder in a disease spectrum that comprises a selflimited, mild, exanthematic, cutaneous variant with minimal oral involvement em minor to a. The cause is unknown, but em frequently occurs in association with herpes simplex virus, suggesting an immunologic process initiated by the virus. Two types, one mild to moderate and one severe, are recognized erythema multiforme minor and erythema multiforme major. Symptoms of em depend on the type of disease you have.
The topic erythema multiforme minor you are seeking is a synonym, or alternative name, or is closely related to the medical condition erythema multiforme. The minor form is additionally subdivided into papular and vesiculobullous variants, and all three have been considered a continuum of the same process. Erythema multiforme em is a rare, acute hypersensitivity reaction most commonly triggered by herpes simplex virus hsv infections. Herpes associated erythema multiformea diagnostic dilemma. The term erythema multiforme em includes a wide and controversial variety of clinical expressions at the present time. Erythema multiforme knowledge for medical students and. Skin biopsy specimens showed findings suggestive of erythema multiforme. Theres also a rare, severe form that can affect the mouth, genitals and eyes and can be lifethreatening. Despite multiple associations, thought to be triggered by hsv in most cases. Erythema multiforme majorrare, usually has other symptoms, is more severe, is less likely go away on its own, and usually caused by medications. Classified as erythema multiforme minor or erythema.
Erythema multiforme british association of dermatologists. Peak incidence in second and third decades of life. Em is usually called minor when mucous membranes are spared or minimally affected. Erythema multiforme em is an acute skin reaction that comes from an infection or another trigger. Erythema exsudativum multiforme swiss dental journal sso. Eryhema multiforme is an acute, selflimited condition characterized by the abrupt onset of symmetrical fixed red papules some of which evolve into target lesions. Erythema multiforme is an acute skin condition characterized by targetoid. Dermis erythema exsudativum multiforme, minor form. Erythema multiforme altmeyers enzyklopadie fachbereich. It is an uncommon disorder, with peak incidence in the second and third decades of life. Erythema multiforme is associated with an acute onset.
The hallmark sign of multiform erythema rash is its target like appearance. Characteristic target irisbulls eyeannular lesions is purpuric, erythematouspapulovesicular lesion resembling target of shooting range q. It occurs predominantly in young adults, is slightly more common in females, and the incidence is somewhere between 0. It is acute and selflimiting, usually resolving without complications erythema multiforme is divided into major and minor. It occurs most commonly in association with the herpes simplex virus as an immune response to the infection.
Erythema multiforme major this is the form that is more severe. Erythema multiforme minor this form is not that serious. Erythema multiforme nord national organization for rare. These lesions appear suddenly on the legs, arms, palms, hands, feet, and inside the mouth. Erythema multiforme minormost common, is generally mild and may go away on its own, and usually caused by a virus. Erythema multiforme em, in its modern definition, is an acute, selflimited syndrome with distinctive skin lesions with or without mucosal lesions. Erythema multiforme caused by oral furosemide jama. Erythema multiforme minor is the most frequent form and is generally mild, erythema multiforme major, while rare, can be lifethreatening. A few people may get the rash after taking certain medications, such as seizure medicines, anesthesia medicines, nonsteroidal antiinflammatory medicines e. Erythema multiforme an overview sciencedirect topics. Enter your email address to receive your free pdf download.
Erythema multiforme em has been divided into a minor simplex form and a major bullous form. Erythema multiforme em is an acute skin condition that may be recurrent in some cases. Erythema multiforme em is an acute selflimited, usually mild, and often. However, erythema multiforme major may be preceded by mild symptoms such as fever. Started in 1995, this collection now contains 6769 interlinked topic pages divided into a tree of 31 specialty books and 732 chapters. There are usually no prodromal symptoms in erythema multiforme minor. Erythema multiforme minor erythema multiforme major stevensjohnson syndrometoxic epidermal polimoorfo panniculitis erythema nodosum acute generalized exanthematous pustulosis. Immunohistochemistry was carried out in a private lab which was found to be positive both for hsv1 igg and hsv2 igm antibody. This study revises the em minor characteristics according to the. Recently, erythema multiforme has been classified as minor, major, stevensjohnson syndrome or toxic epidermal necrolysis, where erythema multiforme minor is the mildest type of lesion and toxic epidermal necrolysis the most severe2,3 table 1. Usually, the diagnosis can be made on the basis of the size, shape, color and distribution of the target lesions.
The rash that is associated with erythema multiforme will usually develop quickly and could be the only symptom that a person has with this medical condition. In most cases, it occurs in response to an infection. Erythema multiforme em is an acute, selflimited skin condition. This is the less severe and most common form of erythema multiform. The spots usually develop over the course of 3 4 days, starting on the hands and feet, and then spreading up the limbs to the trunk and face. In rare cases, it is caused by certain medicines or bodywide. Patients present with oral and lip ulcerations typical of em but without any skin target lesions. Erythema multiforme minor pdf download lcanordaychin. Em is mainly seen in adults between 2040 years of age. Erythema multiforme em refers to a group of hypersensitivity disorders characterized by symmetric red, patchy lesions, primarily on the arms and legs. It may begin at any age, but is most common in children and young adults. Burn of first degree of left thumb nail, initial encounter. A revision article pdf available in american journal of infectious diseases 44 april 2008 with 1,352 reads. The rash lasted over a week, and may have responded.
Eritema multiforme minor pdf republic of fenerbahce. Histologically, each shows varying degrees of dermal and epidermal inflammation and injury. The target lesion is characterized by concentric zones of colour changes with a central dusky or purple zone and an outer red. Erythema multiforme is usually seen in children and young adults aged 2040, especially males. Erythema multiforme is a skin reaction that can be triggered by an infection or some medicines.