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Alternative names Return to top
Lyell's syndrome; Stevens-Johnson syndrome; Toxic epidermal necrolysisDefinition Return to top
Erythema multiforme is a skin disorder resulting from an allergic reaction.Causes, incidence, and risk factors Return to top
Erythema multiforme is a type of hypersensitivity (allergic) reaction that occurs in response to medications, infections, or illness. Medications associated with erythema multiforme include sulfonamides, penicillins, barbiturates, and phenytoin. Associated infections include herpes simplex and mycoplasma infections.Symptoms Return to top
Signs and tests Return to top
The diagnosis is primarily based on the appearance of the skin lesion and its typical symmetrical distribution, especially if there is a history of risk factors or associated diseases.
There may be a positive Nikolsky's sign.
A skin lesion biopsy and microscopic examination may be helpful to differentiate erythema multiforme from other disorders. Erythema multiforme may show tissue death and other changes. Microscopic examination of the tissue may also show antibody deposits.
Treatment Return to top
Treatment goals include control of the underlying causes or illnesses, treatment of the symptoms, and prevention of infection. Suspected medications should be discontinued.Treatment of severe symptoms may include:
Good hygiene and isolation from others may be required to prevent secondary infections.
Extensive skin involvement may cause the loss of large quantities of body fluids, causing shock in addition to the risk of infection. Intensive care with support of body systems may be required.
Skin grafting may be helpful in cases in which large areas of the body are affected.
In cases that are caused by the herpes virus, daily antiviral medications may be prescribed to prevent recurrences of erythema multiforme.
Expectations (prognosis) Return to top
Mild forms of erythema multiforme usually resolve without difficulty in 2 to 6 weeks, but they may recur. More severe forms may be difficult to treat. Stevens-Johnson syndrome and toxic epidermal necrolysis are associated with high death rates.Complications Return to top
Calling your health care provider Return to top
Go to the emergency room or call the local emergency number (such as 911) if symptoms indicate erythema multiforme. Involvement of a large area of the body is an emergency situation. Update Date: 4/15/2003 Updated by: Michael Lehrer, M.D., Department of Dermatology, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network.
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Page last updated: 28 October 2004 |