Erythema multiforme - Eritema Multiforme
☆ En els resultats de la Stiftung Warentest d'Alemanya de 2022, la satisfacció dels consumidors amb ModelDerm va ser només lleugerament inferior a la de les consultes de telemedicina de pagament.
Erythema multiforme minor ― Tingueu en compte que els centres de les lesions poden blanquejar.
La urticària també es pot considerar com un diagnòstic diferencial.
References
Erythema multiforme (EM) és una condició on apareixen taques distintives semblants a un blanc tant a la pell com a les membranes mucoses a causa de reaccions immunitàries. Tot i que sovint es desencadenen per infeccions víriques, especialment el virus de l'herpes simple (HSV) , o determinats medicaments, la causa segueix sent desconeguda en molts casos. El tractament de l'EM aguda se centra a alleujar els símptomes mitjançant cremes que contenen esteroides o antihistamínics. La gestió de l'EM recurrent és més eficaç quan s'adapta a cada pacient. Els enfocaments inicials inclouen tractaments orals i tòpics. Aquests inclouen corticoides i medicaments antivirals. Els tractaments tòpics consisteixen en cremes fortes amb esteroides i solucions per a les mucoses afectades. Per als pacients que no responen als antivirals, les opcions de segona línia inclouen fàrmacs immunodepressius, antibiòtics, antihelmíntics i antipalúdics.
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
En molts casos, el erythema multiforme lleu desapareix per si sol en 2 o 4 setmanes. La síndrome de Stevens-Johnson, una malaltia greu que afecta les mucoses, pot durar fins a 6 setmanes. Normalment, els esteroides no es recomanen per als casos lleus. No se sap si s'han d'utilitzar esteroides per a l'eritema multiforme greu, ja que no hi ha resultats clars d'estudis aleatoris que indiquin quins nens es beneficiaran d'aquest tractament.
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.
Presentem un cas de erythema multiforme (EM) oral causat per TMP/SMX , que mostra úlceres orals i labials típiques sense lesions cutànies. Això subratlla la necessitat de diferenciar-lo d'altres trastorns ulcerosos orals. El pacient va rebre tractament simptomàtic i pastilles de prednisolona, que van provocar una millora després d'aturar la teràpia TMP/SMX.
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 és una reacció que implica la pell i, de vegades, la mucosa, desencadenada pel sistema immunitari. Normalment, es manifesta com a lesions semblants a diana, que poden semblar aïllades, repetir-se o persistir. Aquestes lesions solen afectar simètricament les extremitats, especialment les seves superfícies exteriors. Les principals causes inclouen infeccions com el virus de l'herpes simple i Mycoplasma pneumoniae, així com certs medicaments, immunitzacions i malalties autoimmunes. La distinció de erythema multiforme de la urticària depèn de la durada de les lesions; Les lesions erythema multiforme es mantenen fixes durant almenys set dies, mentre que les lesions urticaris sovint desapareixen en un dia. Tot i que semblant, és crucial diferenciar erythema multiforme de la síndrome de Stevens-Johnson més greu, que normalment presenta màcules eritematoses o purpúriques generalitzades amb butllofes. La gestió de erythema multiforme implica alleujament simptomàtic amb esteroides tòpics o antihistamínics i abordar la causa subjacent. Per als casos recurrents associats al virus de l'herpes simple, es recomana la teràpia antiviral profilàctica. La afectació severa de la mucosa pot requerir l'hospitalització per a líquids intravenosos i substitució d'electròlits.
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.
La condició varia des d'una erupció cutània lleu i autolimitada fins a una forma greu i potencialment mortal coneguda com eritema multiforme major que també afecta les mucoses. La invasió de la membrana mucosa o la presència de bulles són signes importants de gravetat.
- Erythema multiforme minor: dianes típiques o pàpules elevades, edematoses distribuïdes acralment
La forma lleu acostuma a presentar-se amb picor lleu (però la picor pot ser molt severa), taques de color rosa-vermell, disposades simètricament i que comencen a les extremitats. La resolució de l'erupció en 7-10 dies és la norma en aquesta forma de la malaltia.
- Erythema multiforme major: dianes típiques o pàpules elevades i edematoses distribuïdes acralment amb afectació d'una o més mucoses. El despreniment epidèrmic afecta menys del 10% de la superfície corporal total.
○ Tractament - Medicaments OTC
Si s'acompanya de febre (augment de la temperatura corporal), es recomana visitar l'hospital el més aviat possible.
Els fàrmacs sospitosos s'han de suspendre. (per exemple, antibiòtics, antiinflamatoris no esteroides)
Antihistamínics orals com la cetirizina i la loratadina per a la picor.
#Cetirizine [Zytec]
#LevoCetirizine [Xyzal]
#Loratadine [Claritin]