Erythema Multiforme

Erythema multiforme (EM) is an acute, self-limiting, hypersensitivity reaction characterized by target-like lesions on the skin and mucous membranes. It is most commonly triggered by infections, particularly herpes simplex virus (HSV), but can also be associated with medications and other factors.

EM predominantly affects young adults, with a slight male predominance. The condition is classified into two types: erythema multiforme minor and erythema multiforme major. EM minor typically presents with symmetrical, red, target-like lesions primarily on the extremities, while EM major includes mucosal involvement and more extensive skin lesions.

EM symptoms include the sudden onset of erythematous macules, papules, and target lesions that may be pruritic or painful. In EM major, mucosal involvement can lead to painful erosions and ulcerations in the oral cavity, genitalia, and ocular regions.

Treatment for EM focuses on identifying and removing the underlying cause. Supportive care includes the use of topical corticosteroids, antihistamines, and analgesics to manage symptoms. Severe cases of EM major may require systemic corticosteroids and hospitalization for supportive care. Preventive antiviral therapy may be considered in recurrent cases associated with HSV.

References:

• Trayes, K. P., Love, G., & Studdiford, J. S. (2019). Erythema multiforme: Recognition and management. American Family Physician, 100(2), 82-88.
• Lerch, M., & Mainetti, C. (2018). Erythema multiforme. Journal of the European Academy of Dermatology and Venereology, 32(5), 781-788.
• Wetter, D. A., & Davis, M. D. (2010). Recurrent erythema multiforme: Clinical characteristics, etiologic associations, and treatment in a series of 48 patients at Mayo Clinic, 2000 to 2007. Journal of the American Academy of Dermatology, 62(1), 45-53.