Erythema multiforme stevensjohnson syndrome, erythema multiforme major, erythema multiforme. Get a printable copy pdf file of the complete article 619k, or click on a page image below to browse page by page. The minor form is additionally subdivided into papular and vesiculobullous variants, and. Erythema multiforme caused by oral furosemide jama. Both hsv 1 and hsv 2 trigger the erythema multiforme lesions. Among the remaining 42 pa tients 14 girls and 28 boys, 22 had em 11. Find out information about erythema multiforme major. Erythema multiforme em refers to a group of hypersensitivity disorders characterized by symmetric red, patchy lesions, primarily on the arms and legs. Aiepi nut pdf faq frequently asked questions display options. Erythema multiforme erythema multiforme research papers analyze a skin condition that develops from an unknown cause. Panniculitis, inflammation of the subcutaneous fat, is a relatively uncommon condition that usually presents with. Erythema multiforme airuhtheemuh multehformee starts with pink or red blotches.
Medicinenet does not provide medical advice, diagnosis or treatment. Em minor and 11 em major, 17 had sjs, and three had isolated. Erythema multiforme following vaccination in an infant. Experts once believed that erythema multiforme em, stevensjohnson syndrome sjs, and toxic epidermal necrolysis ten were all one disease on a spectrum of severity, with em the. Erythema multiforme new photo for help diagnosis avoid mistakes. Erythema multiforme occurs mainly in young adults and is extremely rare during the neonatal period.
It is an eruption of classic target lesions on the extremities associated with. Erythema multiforme is a hypersensitivity reaction usually triggered by infections, most commonly herpes simplex virus hsv. Erythema annulare centrifugum erythema marginatum erythema migrans erythema gyratum repens. See also introduction to hypersensitivity reactions and inflammatory skin disorders. Recently, erythema multiforme has been classified as minor, major, stevensjohnson syndrome or toxic epidermal necrolysis, where erythema multiforme minor is the mildest type of lesion and. Although there are a few case reports of erythema multiforme following vaccination in literature, the. It occurs predominantly in young adults, is slightly more common in females, and the incidence is somewhere between 0. Retrieved 28 november erythema multiforme minor erythema multiforme major stevensjohnson syndrometoxic epidermal necrolysis panniculitis erythema nodosum acute. Erythema multiforme article about erythema multiforme by. Erythema multiforme is found among people who take ibuprofen, especially for people who are female, 29 old, have been taking the drug for ehealthme. Two cases of erythema multiforme secondary to furosemide have been reported in the past. The incidence of em has been estimated to be between 0.
Some spots can have a small blister or scab in the. Erythema multiforme major in a patient with metastatic. Mucosal involvement in a situation in which erythema multiforme is caused by herpes simplex must be taken into consideration when differentiating between erythema multiforme and. It is estimated that 2040% of cases of erythema multiforme are secondary to herpes. Erythema multiforme em is conventionally separated into em minor and em major. It can present as either a mild rash or a severe, life threatening form known as erythema multiforme major. Unfortunately, this malady has been reported under a variety of labels and eponyms, so that up to very recently the picture was almost a mass of utter confusion. Oral blistering report of two cases of erythema multiforme. Erythema multiforme, stevensjohnson syndrome, toxic. Erythema multiforme major induced by sunitinib for metastatic. Erythema multiforme is a skin condition that develops from an unknown cause.
Herpes associated erythema multiformea diagnostic dilemma. Show full abstract erythema multiforme major is the rarer form and defined by oral, genital, or ocular mucosal erosions or bullae in addition to the classic lesions. Erythema multiforme em is an acute selflimited, usually mild, and often relapsing mucocutaneous syndrome. Erythema multiforme skin disorders merck manuals consumer. Sjs has been called em major in the past but it is now thought to be a distinct entity different. Erythema multiforme major with less than 10% skin involvement of the whole body and involvement of the mucous membrane. This page was last edited on 30 decemberat back links pages that link to this page. Erythema nodosum en is clinically the most frequent form of panniculitis and is considered a reactive process that may be triggered by a wide variety of stimuli.
Pdf erythema multiforme em is an acute, selfhealing. Erythema multiforme british association of dermatologists. A timely and recent editorial in the journal of the american medical. In this view, em major, sjs and ten are considered a single condition, distinguished by degree of epidermal detachment. Even though the minor form of em is frequent than the major form, many other. Erythema multiforme major em major typical targets or raised. The cause is unknown, but em frequently occurs in association with herpes simplex virus, suggesting an immunologic process initiated by the virus.
Erythema multiforme major secondary to a cosmetic facial. Erythema multiforme, stevensjohnson syndrome, and toxic epidermal necrolysis. Erythema multiforme is an inflammatory skin disorder characterized by patches of red, raised skin that often look like targets and usually are distributed symmetrically over the body. December, 62, 8, 2, november, 27, 5, october, 36, 0, september, 30, 3. Full text full text is available as a scanned copy of the original print version. Access a collection of canadian resources on all aspects of english and french, including quizzes. Mucous membrane lesions without cutaneous involvement em is usually called minor when mucous. Cracked, bleeding, crusted, swollen and ulcers of the lips is very characteristic of erythema multiforme, and lip involvement may cause significant morbidity. Links to pubmed are also available for selected references. The lesions usually appear in the hands, feet, extremities, and face. Erythema multiforme em is an acute skin reaction that comes from an infection or another trigger.
Pathogenesis, clinical manifestations, and diagnosis view in chinese. Erythema multiforme major article about erythema multiforme. Media in category erythema multiforme the following 16 files are in this category, out of 16 total. Erythema multiforme may be present within a wide spectrum of severity.
Pdf the authors reported a case of erythema multiforme major characterized by marked diagnostic and therapeutic. Erythema multiforme major induced by sunitinib for. Erythema multiforme em is an acute, selflimited, and sometimes recurring skin condition that is considered to be a type iv hypersensitivity reaction associated with certain. It is now separated from stevens johnson syndrome sjs and toxic epidermal necrolysis t. Erythema multiforme minor em minor typical targets or raised, edematous papules distributed acrally. Erythema multiforme em is a skin condition of unknown cause. Erythema multiforme is a skin reaction that can be triggered by an infection or some medicines. In the second case, no histopathologic findings were presented by the author. This means it usually resolves on its own without treatment. What is erythema multiforme erythema multiforme is a hypersensitivity reaction usually triggered by infections, most commonly herpes simplex virus hsv. Erythema multiforme em majus or erythema multiforme major is sometimes used as a synonym for sjs but is considered to be a different stevensjohnson syndrome and toxic epidermal necrolysis.
An epidemic of erythema multiforme and erythema nodosum. Erythema multiforme mainly affects adults under 40. Snip measures contextual citation impact by wighting citations based on the total number of citations in a subject field. Em with mucosal involvement is known as erythema multiforme major, and without mucosal disease it is referred to as erythema multiforme minor. Mucous membrane lesions without cutaneous involvement em is usually called minor when mucous membranes are spared or minimally affected, for example, lips, and majus or major when at least two mucosal sites are involved. Erythema multiforme stevensjohnson syndrome, erythema multiforme major, erythema multiforme minor, herpesinduced em major, herpesassociated erythema multiforme, druginduced stevensjohnson syndrome 3. Erythema multiforme minor erythema multiforme major stevensjohnson syndrometoxic epidermal necrolysis panniculitis erythema nodosum acute generalized exanthematous pustulosis. A few people may get the rash after taking certain medications, such as seizure medicines, anesthesia medicines, nonsteroidal antiinflammatory medicines e. A depicts the back, b the abdomen, and c the skin findings of erythema multiforme seen in the right forearm. Theres also a rare, severe form that can affect the mouth, genitals and eyes and can be lifethreatening. An epidemiologic investigation provided evidence that histoplasmosis was the cause.
Feb 20, 2020 erythema multiforme em is an acute, selflimited, and sometimes recurring skin condition that is considered to be a type iv hypersensitivity reaction associated with certain infections, medications, and other various triggers. Case summary a 59yearold woman presented to an oral medicine clinic with a chief complaint of mystery disease of 1 years duration. We report a 25dayold girl who presented with target skin lesions on both the palms and soles. There are two variants of this condition, one with mucosal involvement, termed erythema multiforme major, and one without mucosal. Erythema multiforme can be induced by adverse drug reaction with a frequency of more than 1%.
Erythema multiforme for parents nemours kidshealth. Eritema multiforme pediatria pdf yearmonth, html, pdf, epub, total. More recently, however efforts to link disease morphology with cause have led to reconsideration of that dogma. Erythema multiforme is associated with an acute onset. Histologically, each shows varying degrees of dermal and epidermal inflammation and injury. Get a printable copy pdf file of the complete article 619k, or click on a page image below to browse page by. Oral erythema multiforme em major is an acute immunemediated disorder typically involving the oral mucosa, triggered by a hypersensitivity reaction to an antigen. Polycyclic target lesions with alternating rings of erythema and dusky desquamation on the arm. Erythema multiforme is caused by various insults often from an infectious agents, drugs and. We report a 25dayold girl who presented with target skin lesions on both the palms. Nov 14, 2011 erythema multiforme em refers to a group of hypersensitivity disorders characterized by symmetric red, patchy lesions, primarily on the arms and legs.
Erythema multiforme exudativum is by no means a rare disease. Recently, erythema multiforme has been classified as minor, major, stevensjohnson syndrome or toxic epidermal necrolysis, where erythema multiforme minor is the mildest type of lesion and toxic epidermal necrolysis the most severe2,3 table 1. Some spots can have a small blister or scab in the middle. See a picture of and learn about erythema multiforme minor, an immunemediated skin condition in the emedicinehealth image collection gallery. A description of the clinical and epidemiologic features of this unusual epidemic forms the basis of this report. Erythema multiforme following vaccination in an infant sarvjit kaur, sanjeev handa. Erythema multiforme is caused by various insults often from an infectious agents, drugs and food additive 3,4,5. It is acute and selflimiting, usually resolving without complications. It is estimated that 2040% of cases of erythema multiforme are secondary to herpes simplex virus infection. Mucosal involvement in a situation in which erythema multiforme is caused by herpes simplex must be taken into consideration when differentiating between erythema multiforme and stevensjohnson syndrome 2, 3, 10. Em is more common in men than women and 50% are under 20 years of age.
Full text is available as a scanned copy of the original print version. Two types, one mild to moderate and one severe, are recognized erythema multiforme minor and erythema multiforme major. Dec 29, 2019 retrieved 28 november erythema multiforme minor erythema multiforme major stevensjohnson syndrometoxic epidermal necrolysis panniculitis erythema nodosum acute generalized exanthematous pustulosis. Annals of pediatrics is the body of scientific expression of the association and is the vehicle through which members communicate. Diagnosis, classification, and management of erythema multiforme. Erythema multiforme definition of erythema multiforme by.
Mucosal erythema multiforme fuchs syndrome, ectodermosis pluriorificialis. Erythema multiforme research papers on a skin condition. We present a case of erythema multiforme major secondary to nivolumab requiring hospitalization and discontinuation of treatment. Erythema multiforme em has been divided into a minor simplex form and a major bullous form. Erythema multiforme research papers on a skin condition from. Erythema multiforme major em major typical targets or raised, edematous papules distributed acrally with involvement of one or more mucous membranes. Erythema multiforme em majus or erythema multiforme major is sometimes used as a synonym for sjs but is considered to be a different stevensjohnson syndrome and toxic. Management of erythema multiforme associated with recurrent.