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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
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.
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)
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.
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.
The treatment of AGEP begins with the immediate cessation of the offending drug. For individuals developing AGEP while taking multiple drugs, non-essential drugs should be discontinued and essential drugs should be replaced by chemically unrelated drugs that are used as alternatives to the discontinued drug(s).
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.
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