Questions and Answers
What is the characteristic lesion of Erythema Multiforme?
Target or iris lesions
What is the most common form of Erythema Multiforme?
EM minor
Which of the following is a cause of Erythema Multiforme?
Viral infections
What is the typical site of Erythema Multiforme lesions?
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What is the treatment for EM minor?
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What is the severe form of Erythema Multiforme?
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What is the characteristic of EM major?
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Where is the patient with EM major typically treated?
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Study Notes
Erythema Multiforme (EM)
- Acute, self-limiting eruption of skin and mucous membranes characterized by "iris" or "target" lesions.
Etiology
- Unknown exact cause, but associated with:
- Viral infections (HSV, HCV, CMV)
- Drugs (sulphonamides, NSAID)
- X-rays
- Malignancy
- Lupus erythematosus
Clinical Picture
- Two varieties: EM minor and EM major (Steven-Johnson syndrome)
EM Minor
- Presents in 80% of cases
- Characterized by:
- Dull red macules and papules
- Typical and atypical "target" or "iris" lesions (2-3 zones)
- Affects:
- Backs of hands
- Palms
- Wrists
- Extensor aspects of elbows and knees
- Minor mucous membrane affection
EM Major (Steven-Johnson Syndrome)
- Severe form with:
- More extensive mucous membrane affection
- Lesions in the form of:
- Pustules
- Bullae
- Erosions
- Oozing
- Crusts
- Patient is generally ill
- Resolves without complications
Treatment
-
EM Minor:
- Treat underlying cause
- Antihistamines
- Antibiotics
- Topical and systemic steroids
-
EM Major:
- Burn unit care
- Care of mucous membrane lesions
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