Erythema multiforme
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Erythema multiforme minor ― Tabhair faoi deara go bhféadfadh láir na loit a bheith bán.
Is féidir Urtacáire a mheas mar dhiagnóis dhifreálach freisin.
References
Is coinníoll é Erythema multiforme (EM) ina mbíonn spotaí sainiúla cosúil le sprice ar an gcraiceann agus ar na seicní múcasacha de bharr imoibrithe imdhíonachta. Cé gur minic a spreagann ionfhabhtuithe víreasacha iad, go háirithe víreas herpes simplex (HSV) , nó cógais áirithe, tá an chúis fós anaithnid i go leor cásanna. Díríonn cóireáil géarmhíochaine EM ar na hairíonna a mhaolú trí úsáid a bhaint as uachtair ina bhfuil stéaróidigh nó frithhistamíní. Is éifeachtaí EM athfhillteach a bhainistiú nuair a chuirtear in oiriúint do gach othar é. Baineann cur chuige tosaigh le cóireálacha béil agus tráthúla araon. Ina measc seo tá corticosteroids agus míochainí antiviral. Is éard atá i gcóireálacha tráthúla uachtair stéaróideacha láidre agus réitigh le haghaidh seicní múcasacha a bhfuil tionchar orthu. Maidir le hothair nach bhfreagraíonn d’fhrithvíreasach, áirítear ar na roghanna dara líne drugaí a shochtann imdhíonachta, antaibheathaigh, anthelmintics, agus 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
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
I go leor cásanna, imíonn erythema multiforme éadrom leis féin laistigh de 2 go 4 seachtaine. Is féidir le siondróm Stevens-Johnson, riocht tromchúiseach a dhéanann difear do na seicní múcasacha, maireachtáil suas le 6 seachtaine. De ghnáth ní mholtar stéaróidigh i gcásanna éadroma. Tá sé neamhchinnte cé acu ba chóir stéaróidigh a úsáid le haghaidh éiritime multiforme dian ós rud é nach bhfuil aon torthaí soiléire ó staidéir randamach a thugann le fios cé na leanaí a bhainfeadh leas as an gcóireáil seo.
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.
Cuirimid cás de erythema multiforme (EM) ó bhéal i láthair de bharr TMP/SMX , rud a léiríonn othrais béil agus liopaí tipiciúil gan loit chraicinn. Leagann sé seo béim ar an ngá atá le idirdhealú a dhéanamh idir é agus neamhoird othrasúla béil eile. Fuair an t-othar cóireáil shiomptómach agus táibléid prednisolone, rud a d'eascair feabhsú tar éis stop a chur le teiripe 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.
Is imoibriú é Erythema multiforme a bhaineann leis an gcraiceann agus uaireanta an mhúcóis, arna spreagadh ag an gcóras imdhíonachta. Go hiondúil, léirítear é mar loit ar nós sprice, a d’fhéadfadh a bheith scoite amach, athfhillteach nó go seasfaidh siad. Is gnách go mbíonn tionchar siméadrach ag na loit seo ar na foircinn, go háirithe ar a ndromchlaí seachtracha. I measc na bpríomhchúiseanna tá ionfhabhtuithe cosúil le víreas herpes simplex agus Mycoplasma pneumoniae, chomh maith le cógais áirithe, imdhíonadh, agus galair uath-imdhíonachta. Braitheann idirdhealú erythema multiforme ó urtacáire ar fhad na loit; Fanann loit erythema multiforme socraithe ar feadh seacht lá ar a laghad, agus is minic go n-imíonn loit urticáireacha laistigh de lá amháin. Cé go bhfuil sé cosúil leis, tá sé ríthábhachtach idirdhealú a dhéanamh idir erythema multiforme ó shiondróm Stevens-Johnson níos déine, a chuireann macúil erythematous nó purpuric go forleathan i láthair le blisters. Is éard atá i gceist le bainistiú erythema multiforme faoiseamh siomptóim a úsáid le stéaróidigh tráthúla nó le frithhistamíní agus tugtar aghaidh ar an mbunchúis. I gcás cásanna athfhillteacha a bhaineann le víreas herpes simplex, moltar teiripe antiviral próifiolacsach. D'fhéadfadh go mbeadh gá le hospidéil le haghaidh sreabhán infhéitheach agus athsholáthar leictrilít a bheith de dhíth mar gheall ar dhian-bhaint le mucosal.
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.
Athraíonn an riocht ó ghríos éadrom, féin-theoranta go dtí foirm dhian, bagrach don bheatha ar a dtugtar éiritime multiforme major a bhfuil baint aige freisin le seicní múcasacha. Is comharthaí tábhachtacha de dhéine iad ionradh ar an membrane múcasach nó láithreacht bullaes.
- Erythema multiforme minor: spriocanna tipiciúla nó ardaithe, papules edematous dháileadh acrally
Is gnách go mbíonn beagán itchy ar an bhfoirm éadrom (ach is féidir leis an itching a bheith an-dian), blotches bándearg-dearg, socraithe go siméadrach agus ag tosú ar na foircinní. Is é an gríos a réiteach laistigh de 7-10 lá an norm sa bhfoirm seo den ghalar.
- Erythema multiforme major: spriocanna tipiciúla nó papules ardaithe, edematous a dháileadh go hacra le rannpháirtíocht seicní múcasacha amháin nó níos mó. Tá níos lú ná 10% d’achar iomlán an choirp i gceist le díorma eipideirm.
○ Cóireáil - Drugaí OTC
Má tá fiabhras ag gabháil leis (teocht an chomhlachta ag ardú), moltar cuairt a thabhairt ar an ospidéal a luaithe is féidir.
Ba cheart deireadh a chur le drugaí amhrasta. (m.sh. antaibheathaigh, drugaí frith-athlastach neamhsteroidal)
Frithhistamíní ó bhéal mar cetirizine agus loratadine le haghaidh itching.
#Cetirizine [Zytec]
#LevoCetirizine [Xyzal]
#Loratadine [Claritin]