What is Erythema Multiforme?
This medical condition is an inflammatory skin disorder that has many different causes. It is considered a type of hypersensitivity reaction. It affects mainly your forearms, feet, hands, nose, genitals and mouth. It is a rash in which it develops on both sides of your body. For example, if you have it on one leg you will also have it on the other one. It will usually occur in children and young adults. There are two forms of erythema multiforme which are:
- Erythema multiforme minor - this form is not that serious
- Erythema multiforme major - this is the form that is more severe. It is also known as Stevens-Johnson syndrome.
Erythema Multiforme Symptoms
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. When the rash goes away it could turn brownish in color. Some of the other symptoms can include:
- Fever
- Skin itching
- Having a general ill feeling
- Aches in your joints
- Eyes that appear bloodshot
- Have dry eyes
- Eyes that itch, have a discharge, or burn
- You could have eye pain
- Sores in your mouth
- Problems with your vision
You may also have multiple skin lesions that could:
- Start quickly and could return
- Spread
- Appear as a papule, macule, or nodule.
- Look like hives
- Have a central sore that is surrounded by pale red rings
- Be located on your upper body, arms, feet, hands, palms, or legs
- Involve our lips or face
- Be even on both sides known as symmetrical
Causes
Although the exact cause is not known there are many different things that they feel can cause a person to have erythema multiforme. When a person has this medical condition it could start with damage to the blood vessels of your skin. The main two causes are having an infection or an allergic rash.Some of the medications that can cause this type of reaction include:
- Penicillin
- Barbiturates
- Sulfonamides
- Phenytoin
Some of the infections that can cause erythema multiforme are:
- Mycoplasma
- Herpes simplex either genital or oral
If a person has the “minor” form it is usually caused by an infection. If they have the “major” form is usually caused by the reaction to medication.
Diagnosis
When you visit your physician to find out what the rash is they can usually look at your skin and diagnose the problem just by looking at your skin. They may also do tests such as:
- Skin lesion biopsy
- Examining skin tissue under a microscope
- Nikolsky’s sign which is a skin finding in which the top layers of your skin slip away from the lower layers of your skin when it is rubbed slightly. The way this test is done is to place a pencil eraser on your skin and twist it back and forth gently. If the test is positive a blister will form in the area.
Treatment
Most of the time erythema multiforme is self-limiting and will require no treatment but if your physician decides to treat erythema multiforme, treatment can involve:
- Controlling what is causing this medical condition
- Preventing an infection from happening
- Treating whatever the symptoms are
Your physician may have you stop taking any medications that could be the cause of having erythema multiforme. Some of the ways that your physician might have you treat the symptoms can include:
- Taking a medication to help control the itching such as an antihistamine
- Apply moist compresses to the areas of your skin that are affected.
- If the reaction is caused by herpes simplex the physician may have you take oral antiviral medicine.
- To help reduce the discomfort and fever by taking over-the-counter medications like acetaminophen.
- For mouth sores taking topical anesthetics will help to ease the discomfort that can interfere with drinking and eating.
If the symptoms are severe your physician may treat them in these ways.
- For skin infections they may have you take antibiotics
- To control the inflammation have you take corticosteroids
You may need treatment in a burn care or intensive care unit if the cases are severe such as toxic epidermal necrolysis and Stevens-Johnson syndrome. To help prevent getting a secondary infection stay away from other people and practice hygiene. If you have large areas of your body that has been affected is large you may need skin grafting.
