Erythema Multiforme

Overview, Causes, & Risk Factors

Erythema multiforme is a skin reaction that results in red, target-shapedpatches on the skin.

What is going on in the body?

Erythema multiforme is an hypersensitivity reaction commonly caused by aninfection or a medication. The person’s body responds to an organism orchemical with an exaggerated allergic response.

Erythema multiforme can be minor or more severe. The more severe form is alsoknown as Stevens-Johnson syndrome. Severe reactions can involve the skin,lungs, kidneys, eyes, and other areas. Rarely, in severe cases, death may occur.

What are the causes and risks of the condition?

Erythema multiforme is an exaggerated allergic reaction that may be triggeredby the following:

  • medications, such as some drugs used to treat diabetes, seizures, and tuberculosis, as well as nonsteroidal anti-inflammatory drugs (NSAIDs), someantibiotics, and barbiturates
  • infections with viruses, such as herpes simplex, hepatitisA, hepatitis B, measles, mumps, chickenpox, or poliomyelitis
  • infections with bacteria, such as tularemia, tuberculosis, gonorrhea, or certain types of pneumonia
  • infections with a fungus, such as Histoplasma capsulatum.\ The lungs are the usual site of the infection. histoplasmosis
  • cancer, such asleukemia, a type of blood cancer
  • vaccines, such as oral poliovaccine and a combined diphtheria and Clostridium tetani\ bacteria.tetanus vaccine
  • pregnancy
  • radiation therapy
  • Often, the cause is unknown. Erythema multiforme is more common in men than inwomen. Once a person has an episode of erythema multiforme, he or she is morelikely to have more episodes in the future.

    Symptoms & Signs

    What are the signs and symptoms of the condition?

    Signs and symptoms of erythema multiforme include the following:

  • reddish-purple, target-shaped patches on the skin, especially the palms andsoles
  • hive-like, raised swollen areas on the skin that do notclear up like true hives
  • open, tender areas of the surfaces of the mouth, eyes, and genitals
  • general discomfort
  • fatigue
  • fever
  • Severe cases may cause skin peeling and serious eyeinflammation, among other signs and symptoms.

    Diagnosis & Tests

    How is the condition diagnosed?

    Erythema multiforme is usually diagnosed by its appearance. In some cases, askin biopsy may be needed.This involves taking a small piece of skin with a special tool. This piece canthen be analyzed under a microscope to make the diagnosis.

    Prevention & Expectations

    What can be done to prevent the condition?

    Prevention of erythema multiforme is only possible when the cause is known. Ifit is caused by a medication, the medication may need to be stopped.Medications used to treat herpes, such as acyclovir or valacyclovir, may preventrecurrence if the condition is caused by a herpes outbreak. Most cases are notpreventable.

    What are the long-term effects of the condition?

    Scarring or infection of the skin, vision problems, scarring in the gut, andeven death may result from severe forms of erythema multiforme. Most cases donot cause any long-term effects.

    What are the risks to others?

    Erythema multiforme is not contagious and poses no risk to others.

    Treatment & Monitoring

    What are the treatments for the condition?

    Treatment of erythema multiforme may involve the following:

  • stopping the medication causing the problem
  • treating the infection causing the reaction
  • using medications to help the skin heal
  • taking medications to reduce inflammation in the eye
  • treating complications, such as a skin infection
  • debridement, which involves the removal of large areas of damaged skin ordead tissue
  • taking antibiotics for any secondary infection caused by open areas of skin
  • A person with severe erythema multiforme may betransferred to a burn unit for specialized care.

    What are the side effects of the treatments?

    Medications used to treat erythema multiforme may cause upset stomach, rash, orallergic reaction.Debridement of dead tissue may cause bleeding or infection.

    What happens after treatment for the condition?

    Most people recover without a problem and can return to normal activities.However, the person is at higher risk for erythema multiforme in the future. Ifthe condition is caused by herpes, a person may want to consider takingmedications to prevent further herpes outbreaks. If erythema multiforme iscaused by a medication, the person should avoid the medication in the future.

    How is the condition monitored?

    In mild cases, the skin is monitored until the rash disappears. Usually theaffected person can do this monitoring at home. In serious cases, a person may need to be admitted tothe hospital for closer monitoring. Any new or worsening symptoms should bereported to the healthcare provider.

    Article type: xmedgeneral