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The condition varies from a mild, self-limited rash (E. multiforme minor) [4] to a severe, life-threatening form known as erythema multiforme major (or erythema multiforme majus) that also involves mucous membranes. [5] Consensus classification: [6] Erythema multiforme minor—typical targets or raised, edematous papules distributed acrally
In dermatology, erythema multiforme major is a form of rash with skin loss or epidermal detachment. The term "erythema multiforme majus" is sometimes used to imply a bullous (blistering) presentation. [2] According to some sources, there are two conditions included on a spectrum of this same disease process: Stevens–Johnson syndrome (SJS)
Stevens–Johnson syndrome (SJS) is a type of severe skin reaction. [1] Together with toxic epidermal necrolysis (TEN) and Stevens–Johnson/toxic epidermal necrolysis (SJS/TEN) overlap, they are considered febrile mucocutaneous drug reactions and probably part of the same spectrum of disease, with SJS being less severe.
Erythema multiforme (EM) is generally considered a separate condition. [6] Treatment typically takes place in hospital such as in a burn unit or intensive care unit. [3] [7] Efforts include stopping the cause, pain medication, and antihistamines. [3] [4] Antibiotics, intravenous immunoglobulins, and corticosteroids may also be used.
NEH is self-limited and usually resolves without treatment. In the overwhelming majority of the cases, spontaneous resolution occurs within 1–2 weeks. However, if the patient developed NEH after chemotherapy, the offending cytotoxic drug has to be discontinued, and the patient must avoid this particular cytotoxic drug in the future, because ...
Target lesions are the typical lesions of erythema multiforme, in which a vesicle is surrounded by an often hemorrhagic maculopapule. Erythema multiforme is often self-limited, of acute onset, resolves in three to six weeks, and has a cyclical pattern. Its lesions are multiform (polymorphous) and include macules, papules, vesicles, and bullae.
Smooth red-topped small papules which merge into plaques, small fluid-filled blisters (papulovesicles) [2] and less commonly target-shaped lesions which look like erythema multiforme may be visible. [5] In addition, it may occur in other parts of the body in some people treated for inflammatory skin diseases with phototherapy. [2]
Lichenoid lesions are more common among children, presenting on the trunk and limbs, ranging from small red scaly papules to extensive violet to brown papules extending to the face and neck. Within the spectrum of lichenoid presentations are wounds that have features of erythema multiforme and graft-vs.-host disease.