Erythema Multiforme Flashcards
Reaction of blood vessels in dermis
erythema multiforme
What type of lesions are in EM?
target, macule papule, vesicles and bullae in center of lesions
How does EM develop?
over days
How does EM present?
pruritic and painful, bilteral and symmetrical, +/- constitutional symptoms
What are the causes of EM?
Infection Herpes simplex, Mycoplasma Drugs Sulfonamides, phenytoin, barbiturates, phenylbutazone, PCN, allopurinol Idiopathic
What sites are affected in EM?
dorsum of hands PALMS AND SOLES OF FEET Forearms Face Elbows Knees Penis Vulva
What mucous membranes of affected?
Lips Oropharynx Nasal Conjunctival Vulvar Anal
What is EM minor?
HSV Limited mucous membrane involvement Classic target lesions No systemic symptoms Confined to the extremities and face
What is EM major?
Drug reaction
Mucous membrane involvement
Confluent, bullous, erythematous lesions
Systemic symptoms
Who gets EM most often?
men
Who is at high risk of EM?
HIV + Bone marrow transplant SLE Graft vs host disease IBD
What is the work up for EM?
Generally not needed
Clinical Diagnosis
Severe cases
Blood, sputum, and mucosal cultures
What are the supportive tx for EM?
Oral antihistamines Analgesics Local skin care Mouthwashes Avoid the offending agent Antiviral- HSV
What is EM tx for severe cases?
fluid resuscitation, hospititalization
What is EM tx for recurrent cases?
refer to dermatologoy, may need immunosuppressive therapy
