Acta clinica Croatica, Vol. 46 No. 1, 2007.
Case report
Prominent Features and Variations in Clinical Presentation of Erythema
Vedrana Bulat
Liborija Lugović
Mirna Šitum
Abstract
Erythema multiforme (EM) is a heterogeneous syndrome often marked clinically by recurrent episodes of symmetrically distributed round skin lesions that evolve with concentric color changes. The spectrum of EM includes eruptions of typical skin lesions located primarily on the extensor surfaces of extremities (EM minor and EM major) or serious systemic illnesses with erosions on multiple mucosal surfaces along with skin lesions (Stevens-Johnson syndrome, SJS) or confluent areas of epidermal detachment (toxic epidermal necrolysis). Thus, the extent of the disease is quite variable, from typical individual target lesions on the arms or legs without oral lesions, through extensive picture with typical and atypical target lesions on the arms or legs with massive oral involvement and severe general symptoms (SJS). EM usually affects young people and heals within a few weeks, depending on initial involvement. It is considered as a special type of skin reaction to various causative agents such as recurrent herpes simplex virus (HSV) infection, mycoplasma or bacterial infections, rarely drugs, x-rays or sarcoidosis. In many cases, these agents cannot be identified. Therapy includes symptomatic measures for itching and pain, and often prophylactic oral acyclovir for recurrent EM due to HSV. In potentially serious cases, systemic steroids may be appropriately used early in the course to lessen the skin and mucosal damage, but supportive medical care and treatment of secondary infection and other complications are crucial elements of the EM management.
Keywords
Erythema multiforme – pathology; Erythema multiforme – etiology; Skin – immunology; Skin – pathology; Herpes simplex – complications
Hrčak ID:
12713
URI
Publication date:
30.3.2007.
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