Erythema multiforme

Injury	Disease	Nutrition	Poison

Symptoms	Surgery	Test	Special Topic

Erythema multiforme on the hands

Erythema multiforme, circular lesions - hands

Erythema multiforme, target lesions on the palm

Erythema multiforme on the leg

Erythema multiforme on the hand

Exfoliation following erythroderma

Erythema multiforme

Alternative Names:

Lyell's syndrome; Stevens-Johnson syndrome; Toxic epidermal necrolysis
Treatment:

Treatment goals include control of the underlying causes or illnesses, treatment of the symptoms, and prevention of infection. Suspected medications should be discontinued.

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Treatment of mild symptoms may include:

Moist compresses applied to skin lesions
Medications such as antihistamines to control itching
Over-the-counter medications (such as acetaminophen) to reduce fever and discomfort
Topical anesthetics (especially for mouth lesions) to ease discomfort that interferes with eating and drinking

Treatment of severe symptoms may include:

Hospitalization and treatment in an intensive care or burn care unit for severe cases, Stevens-Johnson syndrome, and toxic epidermal necrolysis
Systemic corticosteroids to control inflammation
Intravenous immunoglobulins (IVIG) to stop the process
Antibiotics to control secondary skin infections

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):

Mild forms of erythema multiforme usually resolve without difficulty in 2 - 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:

Permanent skin damage and scarring
Occasionally, lesions on internal organs causing:
- Pneumonitis (lung inflammation)
- Myocarditis (heart inflammation)
- Nephritis (kidney inflammation)
- Hepatitis (liver inflammation)
Secondary skin infection (cellulitis)
Systemic infection, sepsis
Loss of body fluids, shock

Calling your health care provider:

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.