Erythema exsudativum multiforme

Erythema multiforme is an acute vesicular disease of the skin and mucous membranes with a varied clinical picture and a tendency to seasonal recurrences (spring, autumn). The cause is unknown and there is no consensus on it. Apparently it is an immunological response to various infectious stimuli, often arising after angina or a herpes simplex infection (especially HSV-1). Children and adolescents in particular are affected the most.

Clinical picture
It starts with a fever and joint pain (clinically it looks the same as drug allergies). Brick-red, circular spots or papules the size of a lentil appear on the skin, spread to the surrounding area with a red raised border, the center cavernous (erythema annulare), a blister usually spreads from the center - resembling an iris („herpes iris“), the content of the blister is clear to hemorrhagic. Manifestations arise suddenly and they heal ad integrum within a month. Predilection areas include: hands, forearms, insteps, lower legs, face and neck – this form is called erythema exsudativum minus. When the lips, mucous membranes of the mouth, genitals, anus and conjunctiva are affected, it is called erythema exsudativum majus or Stevens-Johnson´s syndrome, which often has a severe course with general symptoms, severe painful erosions and painful when opening the mouth occur. If skin symptoms are missing, it is necessary to differentiate it from the the mucosal pemfigus.

Treatment
Not using suspicious drugs. Corticosteroids or antibiotics.

Related articles

 * Lyell's syndrome
 * Stevens-Johnson´s syndrome