Erythema multiforme
☆ እ.ኤ.አ. በ 2022 ከጀርመን የስቲፍቱንግ ዋረንቴስት ውጤቶች ፣ በሞዴልደርም የተገልጋዮች እርካታ ከሚከፈልባቸው የቴሌሜዲኬን ምክሮች በትንሹ ያነሰ ነበር።
Erythema multiforme minor - የቁስሎቹ ማዕከሎች ሊፈነዱ እንደሚችሉ ልብ ይበሉ።
Urticaria እንዲሁ እንደ ልዩነት ምርመራ ተደርጎ ሊወሰድ ይችላል።
References
Erythema multiforme (EM) በሽታን የመከላከል ምላሾች ምክንያት በቆዳው እና በ mucous ሽፋን ላይ ተለይተው የሚታወቁ ዒላማ መሰል ነጠብጣቦች የሚታዩበት ሁኔታ ነው። ምንም እንኳን ብዙውን ጊዜ በቫይረስ ኢንፌክሽኖች በተለይም በሄፕስ ስፕሌክስ ቫይረስ (HSV) ወይም በአንዳንድ መድሃኒቶች የሚቀሰቀስ ቢሆንም መንስኤው በብዙ ጉዳዮች ላይ አይታወቅም። አጣዳፊ EMን ማከም ስቴሮይድ ወይም ፀረ-ሂስታሚን የያዙ ክሬሞችን በመጠቀም ምልክቶችን በማቃለል ላይ ያተኩራል። ተደጋጋሚ EMን ማስተዳደር ለእያንዳንዱ ታካሚ ሲዘጋጅ በጣም ውጤታማ ነው። የመጀመሪያ አቀራረቦች ሁለቱንም የአፍ እና የአካባቢ ህክምናን ያካትታሉ. እነዚህ ኮርቲሲቶይዶች እና ፀረ-ቫይረስ መድሃኒቶች ያካትታሉ. ወቅታዊ ህክምናዎች ጠንካራ የስቴሮይድ ክሬሞች እና ለተጎዱ የ mucous membranes መፍትሄዎችን ያካትታሉ. ለፀረ-ቫይረስ ምላሽ ለማይችሉ ታካሚዎች, ሁለተኛ-መስመር አማራጮች የበሽታ መከላከያ መድሃኒቶችን, አንቲባዮቲክስ, አንቲሄልሚንቲክስ እና ፀረ ወባዎችን ያካትታሉ.
Erythema multiforme (EM) is an immune-mediated condition that classically presents with discrete targetoid lesions and can involve both mucosal and cutaneous sites. While EM is typically preceded by viral infections, most notably herpes simplex virus (HSV), and certain medications, a large portion of cases are due to an unidentifiable cause. Treatment for acute EM is focused on relieving symptoms with topical steroids or antihistamines. Treatment for recurrent EM is most successful when tailored to individual patients. First line treatment for recurrent EM includes both systemic and topical therapies. Systemic therapies include corticosteroid therapy and antiviral prophylaxis. Topical therapies include high-potency corticosteroids, and antiseptic or anesthetic solutions for mucosal involvement. Second-line therapies for patients who do not respond to antiviral medications include immunosuppressive agents, antibiotics, anthelmintics, and antimalarials
Erythema multiforme (EM) is an immune-mediated condition that classically presents with discrete targetoid lesions and can involve both mucosal and cutaneous sites. While EM is typically preceded by viral infections, most notably herpes simplex virus (HSV), and certain medications, a large portion of cases are due to an unidentifiable cause. Treatment for acute EM is focused on relieving symptoms with topical steroids or antihistamines. Treatment for recurrent EM is most successful when tailored to individual patients. First line treatment for recurrent EM includes both systemic and topical therapies. Systemic therapies include corticosteroid therapy and antiviral prophylaxis. Topical therapies include high-potency corticosteroids, and antiseptic or anesthetic solutions for mucosal involvement. Second-line therapies for patients who do not respond to antiviral medications include immunosuppressive agents, antibiotics, anthelmintics, and antimalarials
በብዙ አጋጣሚዎች መለስተኛ erythema multiforme ከ2 እስከ 4 ሳምንታት ውስጥ በራሱ ይጠፋል። ስቲቨንስ-ጆንሰን ሲንድሮም, የ mucous membranes ላይ ተፅዕኖ ያለው ከባድ ሁኔታ, እስከ 6 ሳምንታት ሊቆይ ይችላል. ስቴሮይድ ለቀላል ጉዳዮች በተለምዶ አይመከርም። ስቴሮይድ ለከባድ erythema multiforme ጥቅም ላይ መዋል የለበትም እርግጠኛ አይደለም ምክንያቱም በዘፈቀደ የተደረጉ ጥናቶች የትኞቹ ህጻናት ከዚህ ህክምና እንደሚጠቅሙ የሚጠቁሙ ግልጽ ግኝቶች የሉም።
In most cases, mild erythema multiforme is self-limited and resolves in 2 to 4 weeks. Stevens-Johnson syndrome is a serious disease that involves the mucous membranes and lasts up to 6 weeks. There is no indication for using steroids for the mild form. Use of steroids for erythema multiforme major is debatable because no randomized studies clearly indicate which children will benefit from this treatment.
In most cases, mild erythema multiforme is self-limited and resolves in 2 to 4 weeks. Stevens-Johnson syndrome is a serious disease that involves the mucous membranes and lasts up to 6 weeks. There is no indication for using steroids for the mild form. Use of steroids for erythema multiforme major is debatable because no randomized studies clearly indicate which children will benefit from this treatment.
በ TMP/SMX የሚከሰት የአፍ እና የከንፈር ቁስለት ያለ የቆዳ ጉዳት የሚታይበትን የአፍ erythema multiforme (EM) ጉዳይ አቅርበናል። ይህ ከሌሎች የአፍ ውስጥ አልሰር ዲስኦርደር በሽታዎች መለየት አስፈላጊ መሆኑን ያጎላል. በሽተኛው የቲኤምፒ / SMX ቴራፒን ካቆመ በኋላ ወደ መሻሻል የሚያመራውን ምልክታዊ ሕክምና እና የፕሬኒሶሎን ታብሌቶችን አግኝቷል.
We report a case of oral erythema multiforme (EM) secondary to TMP/SMX that presented with oral and lip ulcerations typical of EM without any skin lesions and highlights the importance of distinguishing them from other ulcerative disorders involving oral cavity. The patient was treated symptomatically and given tablet prednisolone. The condition improved with stoppage of TMP/SMX therapy.
We report a case of oral erythema multiforme (EM) secondary to TMP/SMX that presented with oral and lip ulcerations typical of EM without any skin lesions and highlights the importance of distinguishing them from other ulcerative disorders involving oral cavity. The patient was treated symptomatically and given tablet prednisolone. The condition improved with stoppage of TMP/SMX therapy.
Erythema multiforme ቆዳን እና አንዳንዴም የተቅማጥ ልስላሴን የሚያጠቃልል ምላሽ ሲሆን ይህም በሽታን የመከላከል ስርአቱ የሚቀሰቅስ ነው። በተለምዶ፣ እንደ ዒላማ መሰል ቁስሎች ይገለጣል፣ እነሱም ተለይተው፣ ሊደጋገሙ ወይም ሊቀጥሉ ይችላሉ። እነዚህ ቁስሎች አብዛኛውን ጊዜ በተመጣጣኝ ሁኔታ ጫፎቹን በተለይም ውጫዊ ንጣፎቻቸውን ይነካሉ። ዋነኞቹ መንስኤዎች እንደ ሄርፒስ ስፕሌክስ ቫይረስ እና Mycoplasma pneumoniae የመሳሰሉ ኢንፌክሽኖች፣ እንዲሁም አንዳንድ መድሃኒቶች፣ ክትባቶች እና ራስን በራስ የሚከላከሉ በሽታዎች ያካትታሉ። ከ urticaria መለየት erythema multiforme በቁስሎች ቆይታ ላይ የተመሰረተ ነው; erythema multiforme ቁስሎች ቢያንስ ለሰባት ቀናት ተስተካክለው ይቆያሉ ፣ የ urticaria ቁስሎች በአንድ ቀን ውስጥ ብዙ ጊዜ ይጠፋሉ ። ምንም እንኳን ተመሳሳይ ቢሆንም፣ erythema multiforme ከከባድ የስቲቨንስ-ጆንሰን ሲንድሮም መለየት በጣም አስፈላጊ ነው፣ይህም በተለምዶ በሰፊው የተንሰራፋ ኤራይቲማቶስ ወይም ፐርፕዩሪክ ማኩላዎች በአረፋ ይያዛሉ። erythema multiforme ማስተዳደር ምልክታዊ እፎይታን በአካባቢያዊ ስቴሮይድ ወይም ፀረ-ሂስታሚኖች እና ዋናውን መንስኤ መፍታትን ያካትታል። ከሄፕስ ፒስ ቫይረስ ጋር በተያያዙ ተደጋጋሚ ጉዳዮች, ፕሮፊለቲክ ፀረ-ቫይረስ ሕክምናን ይመከራል. ከባድ የ mucosal ተሳትፎ ለደም ሥር ፈሳሾች እና ኤሌክትሮላይት መተካት ሆስፒታል መተኛት ሊያስፈልግ ይችላል.
Erythema multiforme is a reaction involving the skin and sometimes the mucosa, triggered by the immune system. Typically, it manifests as target-like lesions, which may appear isolated, recur, or persist. These lesions usually symmetrically affect the extremities, particularly their outer surfaces. The main causes include infections like herpes simplex virus and Mycoplasma pneumoniae, as well as certain medications, immunizations, and autoimmune diseases. Distinguishing erythema multiforme from urticaria relies on the duration of lesions; erythema multiforme lesions remain fixed for at least seven days, while urticarial lesions often vanish within a day. Although similar, it's crucial to differentiate erythema multiforme from the more severe Stevens-Johnson syndrome, which typically presents widespread erythematous or purpuric macules with blisters. Managing erythema multiforme involves symptomatic relief with topical steroids or antihistamines and addressing the underlying cause. For recurrent cases associated with herpes simplex virus, prophylactic antiviral therapy is recommended. Severe mucosal involvement may necessitate hospitalization for intravenous fluids and electrolyte replacement.
Erythema multiforme is a reaction involving the skin and sometimes the mucosa, triggered by the immune system. Typically, it manifests as target-like lesions, which may appear isolated, recur, or persist. These lesions usually symmetrically affect the extremities, particularly their outer surfaces. The main causes include infections like herpes simplex virus and Mycoplasma pneumoniae, as well as certain medications, immunizations, and autoimmune diseases. Distinguishing erythema multiforme from urticaria relies on the duration of lesions; erythema multiforme lesions remain fixed for at least seven days, while urticarial lesions often vanish within a day. Although similar, it's crucial to differentiate erythema multiforme from the more severe Stevens-Johnson syndrome, which typically presents widespread erythematous or purpuric macules with blisters. Managing erythema multiforme involves symptomatic relief with topical steroids or antihistamines and addressing the underlying cause. For recurrent cases associated with herpes simplex virus, prophylactic antiviral therapy is recommended. Severe mucosal involvement may necessitate hospitalization for intravenous fluids and electrolyte replacement.
ሁኔታው ከመለስተኛ፣ ራስን-ውሱን ሽፍታ እስከ ከባድ፣ ለሕይወት አስጊ የሆነ erythema multiforme major በመባል የሚታወቅ ሲሆን ይህም የ mucous membranesንም ያካትታል። የ mucous membrane ወረራ ወይም ቡላዎች መኖራቸው የክብደት ምልክቶች ናቸው።
- Erythema multiforme minor: የተለመዱ ዒላማዎች ወይም የተነሱ, የ edematous papules በአክራሪነት ተሰራጭተዋል
መለስተኛ ቅርጽ ብዙውን ጊዜ በመጠኑ ማሳከክ (ነገር ግን ማሳከክ በጣም ከባድ ሊሆን ይችላል) ፣ ሮዝ-ቀይ ነጠብጣቦች ፣ በተመጣጣኝ ሁኔታ የተደረደሩ እና ከጫፎቹ ላይ ይጀምራል። በ 7-10 ቀናት ውስጥ ሽፍታው መፍትሄ በዚህ አይነት በሽታ የተለመደ ነው.
- Erythema multiforme major: የተለመዱ ኢላማዎች ወይም ያደጉ, ኤድማቲክ ፓፒሎች ከአንድ ወይም ከዚያ በላይ የ mucous membranes ተሳትፎ ጋር በአክራሪነት ተሰራጭተዋል. Epidermal detachment ከጠቅላላው የሰውነት ወለል ከ 10% ያነሰ ያካትታል.
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