43 - Erythema Multiforme Flashcards
EM minor vs major
Minor - skin and lips only
Major - with mucous membrane involvement
Typical vs atypical EM major
Typical - typical targets on the extremities
Atypical - more extensive distribution of atypical, larger targets
Erosions of the eyes and mouth and a transient skin eruption
Fuchs syndrome or
Ectodermosis pluriorificialis or
Mucosal EMM
EM is more prevalent in _____ and has a _____ preponderance
Adolescents and young adults
Male
EM recurrence usually more frequent in _____-associated cases
HSV
Average interval of EM developing after HSV infection
7 days (range, 12-17 days)
Y/N: EM usually follows primary HSV infection.
No - EM usually follows recurrent herpes but may also occur after primary HSV infection.
In most patients, all EM lesions appear within
3 days
EM lesions often first appear (proximally/distally) and then spread in a (centrifugal/centripetal) manner
Distally
Centripetal
EM lesions are usually (symptomatic/asymptomatic)
Asymptomatic
Typical target lesions consist of
- Dusky central disk of blister
- Infiltrated pale ring
- Erythematous halo
Lesions of EM are all _____, in contrast to _____, which are the typical lesions in epidermal necrolysis.
Papules
Macules
Central bulla and a marginal ring of vesicles
Herpes iris of Bateman
Duration of an individual EM lesion is shorter than
2 weeks
Most common cause of EM
HSV (usually HSV-1)
Second major cause of EM overall and the first in children
M. pneumoniae
M. pneumoniae vs HSV-associated EM
M. pneumoniae - atypical and more severe
Histopathologic appearance of EM vs EN
EN - dermal inflammation is moderate to absent and epidermal necrosis is much more pronounced
Frequency and severity of recurrent EM tends to (increase/decrease) over time
Decrease
Prolonged series of overlapping attacks of EM
Continuous or persistent EM
Y/N: Administering anti-HSV drugs for the treatment of an established episode of postherpetic EM is recommended.
No - useless
Treatment for symptomatic patients with M. pneumoniae-associated HSV
Macrolides in children
Macrolides or quinolones in adults
Effective at preventing recurrences of herpes-associated EM
Continuous therapy with oral anti-HSV drugs
Most effective treatment of recurrent or persistent cases of EM when anti-HSV drugs have failed
Thalidomide
