60 Questions
What is the common layman term for after lesions?
Canker sores
What is the derived meaning of the term 'afters'?
Ulcer
What is the suspected cause of after lesions?
T cell mediated immunologic reaction
What is the role of TNF alpha in the pathogenesis of after lesions?
It is an inflammatory cytokine causing destruction of tissue
What is the suspected genetic component in the development of after lesions?
Certain patients could be genetically predisposed
What is the term 'afters' already indicative of?
It's an ulcerated lesion
Which factor contributes to the development of aphthous ulcers?
Nutritional deficiencies
What is a contributing factor to the development of minor aphthous ulcers?
Predominantly seen in children, teenagers, and young adults
What is a clinical variant of aphthous ulcers?
Major lesions
What can trigger aphthous ulcers?
Inflammatory bowel diseases
What is the age range where patients often develop their first aphthous ulcers?
Before the age of 30
How long does it take for minor aphthous ulcers to heal?
Within 7 to 10 days
Where are minor aphthous ulcers likely to occur?
On movable, non-keratinized mucosa
What is a common prodromal symptom experienced by patients before developing oral aphthous ulcers?
Burning, pain, and tingling in the affected area
What is the typical size range of the ulcers associated with oral aphthous ulcers?
1mm to 5mm
Where are major aphthous ulcers commonly found?
Labial mucosa, soft palate, and lower labial mucosa
What is a challenging aspect of diagnosing major aphthous ulcers?
Excluding other conditions such as tuberculosis, fungal infections, or cyclic neutropenia ulcers
What is a characteristic of herpetiform aphthous ulcers?
They present as clusters of ulcers in one location, followed by another crop in a different location
Which of the following is a characteristic of oral ulcers in Behcet syndrome?
They resemble herpetiform lesions
What is a common management approach for Behcet syndrome?
Topical anesthetics
What is a known trigger for the ulcers in Behcet syndrome?
Dietary factors
Which organ systems can be affected by Behcet syndrome?
Central nervous and renal systems
What is the racial predilection of Behcet syndrome?
More common in black patients
What is a common manifestation of ocular involvement in Behcet syndrome?
Uveitis and conjunctivitis
What is the major triggering factor for most patients with erythema multiforme?
Herpes simplex virus infection
Which oral lesions are typically involved in erythema multiforme?
Labial mucosa, vermilion, tongue, buccal mucosa, and soft palate
What is the classic presentation of erythema multiforme?
Hemorrhagic crusting of the lips, covered with dried blood
How long does erythema multiforme typically take to heal?
2 to 6 weeks
What is crucial for the management of erythema multiforme?
Identifying the initiating factor, such as herpes infection or medications
Which condition tends to affect younger patients compared to toxic epidermal necrolysis?
Stevens-Johnson syndrome
What is the layman term for after lesions?
Canker sores
What is the meaning of the term 'afters'?
It already means it's an ulcerated lesion
What is the suspected cause of after lesions?
T cell mediated immunologic reaction with production of TNF alpha
What is the common trigger for after lesions in some patients?
Chocolates
What is the role of TNF alpha in the pathogenesis of after lesions?
It is an inflammatory cytokine causing destruction and ulceration
What is the suspected component in the development of after lesions?
Genetic predisposition
What is a contributing factor to the development of minor aphthous ulcers?
Trauma to the oral soft tissues
What is a clinical variant of aphthous ulcers?
Herpetiform lesions
Where are minor aphthous ulcers likely to occur?
On movable mucosa
What is a characteristic of herpetiform aphthous ulcers?
Multiple small ulcers
What is a common manifestation of ocular involvement in Behcet syndrome?
Keratitis
What is a common trigger for aphthous ulcers?
Inflammatory bowel diseases
What is a challenging aspect of diagnosing Behcet syndrome?
Identifying the exact trigger for the ulcers
What is a known trigger for the ulcers in Behcet syndrome?
Environmental antigens
What is a characteristic of herpetiform aphthous ulcers?
Heal in 7 to 10 days
What is a common manifestation of ocular involvement in Behcet syndrome?
Uveitis
What is the racial predilection of Behcet syndrome?
More common in black patients
Where are minor aphthous ulcers likely to occur?
In the anterior part of the oral mucosa
Which type of aphthous ulcers are exclusively located on movable, non-keratinized mucosa?
Minor aphthous ulcers
What is the typical healing time for major aphthous ulcers?
2 to 6 weeks
What is a rare variant of aphthous ulcers, mostly seen in adults, involving the movable mucosa with a female predominance?
Herpetiform aphthous ulcers
Which condition is often required to be excluded when diagnosing major aphthous ulcers?
All of the above
What is the size range of the ulcers associated with oral aphthous ulcers?
1mm to 5mm
Where are oral aphthous ulcers unlikely to occur?
Hard palate
Which of the following is a characteristic of the skin lesions in erythema multiforme?
Targeted or bullseye lesions with concentric circular erythematous rings
What is the typical presentation of oral lesions in erythema multiforme?
Involvement of the labial mucosa, vermilion, tongue, buccal mucosa, and soft palate
Which condition is more severe and involves more than 30% of the body surface?
Toxic epidermal necrolysis
What is the classic presentation of erythema multiforme?
Hemorrhagic crusting of the lips, covered with dried blood
What is the major triggering factor for most patients with erythema multiforme?
Herpes simplex virus infection
What are the prodromal symptoms that patients with erythema multiforme may present with?
Headache, malaise, sore throat, and cough
Study Notes
Erythema Multiforme: Clinical Features, Diagnosis, and Management
- Erythema multiforme is a blistering ulcerative micro cutaneous disease with uncertain pathogenesis, believed to be immunologically mediated.
- The major triggering factor for most patients is herpes simplex virus infection.
- Patients with erythema multiforme may present with prodromal symptoms such as headache, malaise, sore throat, and cough one week before the development of skin lesions.
- Skin lesions are described as targeted or bullseye lesions, with concentric circular erythematous rings on the extremities or face.
- Oral lesions typically involve the labial mucosa, vermilion, tongue, buccal mucosa, and soft palate, with sparing of the gingiva.
- The classic presentation of erythema multiforme includes hemorrhagic crusting of the lips, covered with dried blood.
- Erythema multiforme is a self-limiting condition that heals within 2 to 6 weeks and is managed with topical or systemic corticosteroids.
- Intravenous rehydration may be necessary for patients with severe oral ulcers.
- Identifying the initiating factor, such as herpes infection or medications, is crucial for management.
- Toxic epidermal necrolysis and Stevens-Johnson syndrome are severe conditions with different pathogenesis from erythema multiforme, mainly triggered by medications.
- Stevens-Johnson syndrome tends to affect younger patients, while toxic epidermal necrolysis affects older patients and is more severe, involving more than 30% of the body surface.
- Patients with these conditions develop flu-like symptoms before the onset of skin lesions.
Erythema Multiforme: Clinical Features, Diagnosis, and Management
- Erythema multiforme is a blistering ulcerative micro cutaneous disease with uncertain pathogenesis, believed to be immunologically mediated.
- The major triggering factor for most patients is herpes simplex virus infection.
- Patients with erythema multiforme may present with prodromal symptoms such as headache, malaise, sore throat, and cough one week before the development of skin lesions.
- Skin lesions are described as targeted or bullseye lesions, with concentric circular erythematous rings on the extremities or face.
- Oral lesions typically involve the labial mucosa, vermilion, tongue, buccal mucosa, and soft palate, with sparing of the gingiva.
- The classic presentation of erythema multiforme includes hemorrhagic crusting of the lips, covered with dried blood.
- Erythema multiforme is a self-limiting condition that heals within 2 to 6 weeks and is managed with topical or systemic corticosteroids.
- Intravenous rehydration may be necessary for patients with severe oral ulcers.
- Identifying the initiating factor, such as herpes infection or medications, is crucial for management.
- Toxic epidermal necrolysis and Stevens-Johnson syndrome are severe conditions with different pathogenesis from erythema multiforme, mainly triggered by medications.
- Stevens-Johnson syndrome tends to affect younger patients, while toxic epidermal necrolysis affects older patients and is more severe, involving more than 30% of the body surface.
- Patients with these conditions develop flu-like symptoms before the onset of skin lesions.
Test your knowledge of erythema multiforme with this quiz on the clinical features, diagnosis, and management of this blistering cutaneous disease. Explore its association with herpes simplex virus infection, characteristic skin and oral lesions, and the appropriate management strategies. Also, learn about the differences between erythema multiforme, toxic epidermal necrolysis, and Stevens-Johnson syndrome.
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