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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)
The diagnosis is based on involvement of less than 10% of the skin. [2] It is known as TEN when more than 30% of the skin is involved and an intermediate form with 10 to 30% involvement. [3] A positive Nikolsky's sign is helpful in the diagnosis of SJS and TEN. [9] A skin biopsy is helpful, but not required, to establish a diagnosis of SJS and ...
Some of the most severe and life-threatening examples of drug eruptions are erythema multiforme, Stevens–Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), hypersensitivity vasculitis, drug induced hypersensitivity syndrome (DIHS), erythroderma and acute generalized exanthematous pustulosis (AGEP). [4]
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.
TEN is a type of severe cutaneous adverse reactions (SCARs), together with SJS, a SJS/TEN, and drug reaction with eosinophilia and systemic symptoms. [5] It is called SJS when less than 10% of the skin is involved and an intermediate form with 10 to 30% involvement. [3] Erythema multiforme (EM) is generally considered a separate condition. [6]
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.
Most commonly, athlete's foot can lead to localised vesicles on hands, bacterial infections to erythema nodosum and herpes simplex virus to erythema multiforme. [2] [3] The diagnosis is frequently made by treating the initial triggering skin problem and observing the improvement in the eczematous rash. Both the initial skin problem and the id ...