Erythema multiforme exudative can be mild or severe. Blisters and erythematous-edematous changes appearing on the skin and mucous membranes are typical of this disease. When can the exudative erythema multiforme appear and how is it treated?

Erythema exudative exudative erythema(erythema exudativum multiforme - EM) is an acute, periodic disease characterized by the formation of well-defined erythema on the skin and mucous membranes, sometimes with blisters.

Erythema multiforme exudative: causes

The causes of exudative erythema multiforme are not fully known. It is believed to be the result of the immune system not responding properly to certain factors. We know which cells of the immune system cause this reaction, but why it is, what causes it - it has not been established yet. These factors are:

Infections most often cause a mild form of erythema multiforme, and medications - Stevens-Johnson-Lyell syndrome.

  • viruses, bacteria - erythema multiforme often accompanies infections caused by viruses or bacteria. "In children and adolescents, these are usually flu-like infections, upper respiratory tract infections, or mycoplasma infections," the drug says. med. Agnieszka Bańka-Wrona, from the DERMEA General and Aesthetic Dermatology Clinic. In young adults, and in this group more often in men, erythema multiforme is usually associated with infection with the herpes simplex virus ( Herpes simplex ), usually labial herpes, sometimes genital herpes. Skin lesions do not contain a virus, so they are not contagious - adds the expert
  • drugs - most often from the group of sulfonamides, salicylates, anticonvulsants (especially barbiturates), ibuprofen, administered in a standard dose, in the right way, for prophylactic, diagnostic or therapeutic purposes
  • chemical agents

Erythema multiforme exudative: mild to severe. Symptoms of erythema multiforme

1) Mild character

Diseases are characteristic of the mild form of exudative erythema multiforme are lesions on the skin with a concentric arrangement, resembling a target. They are actually in their mild formonly on the skin, most often around the mouth, distal parts of the limbs (i.e. from the knees down and from the elbows down). Blisters are rare.

- The characteristic feature of erythema multiforme is recurrence, says the drug. med. Agnieszka Bańka-Wrona. From time to time, the disease re-develops, e.g. after an infection with herpes labialis. Such patients must take long-term antiviral medications. Sometimes withdrawal is a problem, because any attempt to stop taking them causes the disease to come back. Therefore, some people have to take these medications for many months. However, you cannot promise the patient that if he takes the medication for six months, the erythema will not come back - adds the expert.

According to an expertbow. Agnieszka Bańka-Wrona, General and Aesthetic Dermatology DERMEA

Stress exacerbates the symptoms of erythema multiforme

The symptoms of erythema often worsen during prolonged stress. Strong stress causes weakening of the body, herpes often appear then, and the next stage is the rapid multiplication of the Herpes simplex virus and the development of all the body's reactions characteristic of erythema. The same mechanism is revealed after severe infections, which, like stress, severely strain the immune system.

2) Heavy character

  • Stevens-Johnson syndrome (Latin erythema multiforme major, SJS, Stevens-Johnson Syndrome)

In the course of the disease, there are numerous erythematous and blistering lesions on the skin of the whole body, as well as blisters and erosions on the mucosa of the oral cavity and genitourinary organs.

Stevens-Johnson syndrome has a 5 percent burden. a Lyell's syndrome - 30 percent mortality.

  • Lyell's syndrome, or toxic epidermal necrolysis syndrome (Latin erythema multiforme major)

This is the most severe form of erythema multiforme. In this case, blisters form on the vast areas of the body, and the epidermis coalesces and creams in whole flaps. A higher incidence of toxic epidermal necrolysis syndrome is observed in HIV carriers, in patients suffering from autoimmune diseases and in the elderly.

Due to a much more severe course and a lower tendency to relapse, Stevens-Johnson syndrome and toxic epidermal necrolysis syndrome are sometimes classified as separate disease entities, and only mild erythema is referred to as its mild form.

Erythema multiforme exudative: treatment

Mild exudative erythema multiforme is treated causally (if the causative factor was the drug - drug discontinuation,if the background is an infectious agent - treatment of a specific infection)

Medications are administered in treatment:

  • general - systemic glucocorticosteroids, antibiotics, antiviral drugs.
  • topical - antibiotics, antifungal drugs, glucocorticosteroids, painkillers, and in cases of large body surface areas, anti-burn dressings are used
  • symptomatic medications - antipyretic and analgesic medications

The most severely treated is toxic epidermal necrolysis syndrome. Typically, the patient will require hospitalization in an Intensive Care Unit or a burn unit, and treatment is similar to that for a burn disease. After undergoing Lyell's syndrome, periodic ophthalmological inspection is also necessary due to the possibility of complications from the organ of vision.

According to an expertbow. Agnieszka Bańka-Wrona, General and Aesthetic Dermatology DERMEA

Complications of erythema multiforme may be superinfection of wounds formed on the skin and mucous membranes, therefore the basis of care in these cases is the use of mild disinfectants, antibacterial and antifungal agents. In the case of erosions and hemorrhagic scabs in the oral cavity and on the lips, it is recommended to eat rubbed, semi-liquid and liquid foods, not too much seasoned. The most dangerous are ophthalmic complications and adhesions in the genital area. If changes in the genitals occur, intercourse is discouraged. Intimate contacts cause mechanical damage that widens the area of ​​the disease. Fatal cases only concern Stevens-Jonson syndrome or Lyell's syndrome, which are currently considered by most authors of scientific publications as a separate disease entity classified as severe drug reactions (they can be caused by, among others, non-steroidal anti-inflammatory drugs, antiepileptic drugs, allopurinol, ACE-I, beta-blockers, sulfonamides).

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