What Is Erythema Multiforme?

Polymorphous erythema is an acute inflammatory skin disease, which is self-limiting. The rash is polymorphic, including erythema, pimples, wind masses, and blistering. The characteristic skin lesions are target-shaped lesions, namely iris-like rashes, with varying degrees of mucosal damage. A few Visceral damage. The disease occurs frequently in spring and autumn, and is more common in children and young women.

Basic Information

nickname

Polymorphic exudative erythema

English name

Erythema Multiforme

Visiting department

dermatology

Multiple groups

More common in children and young women.

Common causes

Related to infections, drugs, contacts, visceral diseases, etc.

Common symptoms

Headaches, fever, joint and muscle soreness, tonsillitis, and respiratory infections; rashes are polymorphous, with erythema, pimples, wind masses, blisters, bullae, and purpura, etc.

Erythema polymorpha

Infection

Bacteria, Rickettsia, Mycoplasma, Borrelia, Chlamydia, viruses, fungi, parasites and other infections are possible. Herpes simplex infections are the most common.

2. Drugs

Antibiotics, anticonvulsants, aspirin, antituberculosis drugs, antifungal drugs, etc. Common sensitizing drugs are sulfa drugs, penicillins, non-hormonal anti-inflammatory drugs, antiepileptic drugs and so on.

3. Contact

Such as primrose, ivy, capsaicin, rosin, formaldehyde, nickel and so on.

4. Disease

Connective tissue disease, vasculitis, non-Hodgkin's lymphoma, leukemia, multiple myeloma, etc.

5. Other

Tattoos, food (orange berries), physical factors (radiation, cold, sun), etc.

Clinical manifestations of erythema polymorpha

Prodromal symptoms include headache, fever, limb burnout, loss of appetite, joint and muscle aches, tonsillitis, and respiratory infections. The rash is polymorphic, with erythema, pimples, wind masses, blisters, bullae, and purpura. Clinical type 3:

Erythematous papular type

The most common, mild type, is mostly related to herpes simplex virus infection. The rash is mainly erythema and pimples, and wind masses are also seen, which are distributed on the sides of the extremities. Fully developed erythema can form target-shaped lesions. The rash is exacerbated after exposure to light, with isomorphic reactions, mild itching, and mild mucosal damage, often limited to the oral mucosa.

2. Limited blister type

Between mild and severe. The rash is mainly blister. There is a blister in the center of the erythema or the erythema is surrounded by a blister. The number of rashes is not large. It is limited to the extremities and has mucosal damage.

3. Severe

Before the onset, there are prodromal symptoms, the number of erythema is large, mainly distributed in the limbs, often spread to the trunk, there are most typical target-shaped damage, fever, serious mucosal damage, which can affect the mucosa of 2 parts. Enlargement of superficial lymph nodes throughout the body.

Polymorphic erythema diagnosis

The disease has a variety of rashes, typical target-shaped lesions, and is common in the extremities. It is symmetrically distributed, with mucosal damage, and severe cases have fever and other systemic symptoms. Histopathology has individual keratinocyte necrosis, and skin lesions when combined with HSV infection. Site HSV antigen test was positive.

Polymorphous erythema treatment

Cause treatment

If the cause is clear, the cause is treated.

Local treatment

For skin lesions, you can use cleansing, protection, antipruritic, mild anti-inflammatory agents, such as vegetable oil, calamine lotion, zinc oxide oil, silicone oil cream, glucocorticoid ointment and so on. Oral lesions should be rinsed to keep the mouth clean. For eye diseases, please consult an eye clinic as soon as possible. The anus, urethral opening and external genital area can be cleaned with 0.05% chlorhexidine solution, and antibiotics should be applied in time when there is infection.

3. Systemic treatment

(1) Oral antihistamines, multivitamins, and supplementation of water and nutrition in critical cases to maintain water and electrolyte balance.

(2) Early, short-term, and systematic application of glucocorticoids to severe cases can control the development of the disease in time, reduce symptoms and shorten the course of the disease.

(3) Severe cases can be treated with intravenous immunoglobulin, especially for those with poor curative effects or contraindications to glucocorticoids.

(4) Others: levamisole, cyclophosphamide, cyclosporine, dapsone, thalidomide, etc. can be applied.