Erythema multiforme by aseem
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Erythema multiforme is an acute, recurrent skin condition characterized by target-shaped lesions that commonly appear on the extremities and face. It is caused by herpes simplex virus or Mycoplasma pneumoniae infections triggering an immune response in genetically predisposed individuals. The condition ranges from isolated skin involvement to more severe cases affecting the mucous membranes. Treatment focuses on managing underlying infections, reducing symptoms with corticosteroids, and preventing recurrences with antivirals.
Erythema multiforme by aseem
- 2. INTRODUCTION 2 Erythema – Redness ; Multiforme – Polymorphic First Classified by Bastuji – Garin et al to separate from SJS / TEN in 1922 described by Hebra in 1866 as Erythema exudativum Multiforme 12/29/2013
- 3. DEFINITION 3 Acute, Recurrent, self-limiting Cutaneous and/or Mucocutaneous eruptions characterised by target – shaped plaques commonly over extremities and face. Assoc with HSV / Mycoplasma pneumonia infections 12/29/2013
- 4. EPIDEMIOLOGY 4 Male : Female = 3:2 Occurs in the young / adoloscents Recurrent in 30 % Familial clustering s/o Infective Etiology Assoc with HLA – DQB1 * 0301 Allele 12/29/2013
- 6. CLASSIFICATION 6 EM Minor : Cutaneous without Mucous inv EM Major (EMM) : Cutaneous + Mucous inv Mucosal EM : Fuch’s Ectodermosis Pluriorificialis HAEM MPAEM 12/29/2013
- 7. CLINICAL FEATURES 7 Prodromal Features Prev Attack (30%) Preceding Infection Fever (T>103.1 deg C) Cutaneous Lesions Mucous Lesions 12/29/2013
- 8. CUTANEOUS LESIONS 8 Symmetrical, Acral, Centripetal Rash Extensor aspect : Extremities > Face > Neck > Trunk Predilection to Sun-Exposed Areas / Koebnerization Well-defined, circular, blanching papule / plaque that persists for 01 week – Self-limiting in 04 weeks – Persistent / Continuous EM 12/29/2013
- 9. CUTANEOUS LESIONS 9 Typical Target Lesion :- 1. Dusky Central Disk / Bulla (later Violaceous / Purpuric) 2. Infiltrated Pale Ring 3. Erythematous edematous halo Larger lesions show Central Bulla and Marginal ring of vesicles - Herpes Iris of Bateman 12/29/2013
- 11. CUTANEOUS LESIONS 11 Raised Atypical Target lesions / Targetoid lesions SJS-TEN lesions – mostly Macular 12/29/2013
- 12. MUCOSAL LESIONS 12 70% Cases Lips – Cutaneous Target Lesions Serous Crusting 12/29/2013
- 13. MUCOSAL LESIONS 13 LIPS – Mucosal (Erosions / Vesicles / Bullae) GINGIVAL / Ventral Tongue Hard Palate – Spared Pharynx / Larynx / Trachea / Bronchi Conjunctivitis B/L with Vesicles / Erosions Nasal / Urethral / Anal Mucosae 2/3 Mucosal Sites sans Cutaneous inv – FUCH’s SYNDROME 12/29/2013
- 14. 14 12/29/2013
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- 18. TREATMENT 18 Treating underlying Etiology Reducing morbidity – Oral CS Anti-Virals ? Macrolides / Quinolones for MPAEM Oral EM – Topical CS / Anesthetics / Antacids 12/29/2013
- 19. RECURRENT EM 19 Anti-Virals Topical Acyclovir ? Azathioprine Thalidomide 12/29/2013