Erythema multiforme - Eritema Multiforme
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Erythema multiforme minor ― Teña en conta que os centros das lesións poden branquear.
A urticaria tamén se pode considerar como un diagnóstico diferencial.
relevance score : -100.0%
ReferencesErythema multiforme (EM) é unha afección na que aparecen manchas distintivas semellantes a diana tanto na pel como nas mucosas debido a reaccións inmunes. Aínda que moitas veces se desencadea por infeccións virais, especialmente o virus do herpes simple (HSV), ou por certos medicamentos, a causa segue sendo descoñecida en moitos casos. O tratamento da EM aguda céntrase en aliviar os síntomas mediante cremas que conteñen esteroides ou antihistamínicos. A xestión da EM recorrente é máis eficaz cando se adapta a cada paciente; os enfoques iniciais inclúen tratamentos orais e tópicos, como corticosteroides e antivirais. Os tratamentos tópicos consisten en cremas de esteroides fortes e solucións para as membranas mucosas afectadas. Para os pacientes que non responden aos antivirais, as opcións de segunda liña inclúen inmunosupresores, antibióticos, antihelmínticos e antipalúdicos.
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 moitos casos, o erythema multiforme leve desaparece por si só entre 2 e 4 semanas. A síndrome de Stevens‑Johnson, unha condición grave que afecta as membranas mucosas, pode durar ata 6 semanas. Os esteroides normalmente non se recomendan para casos leves. Non se sabe se os esteroides deben usarse para o erythema multiforme grave, xa que non hai resultados claros de ensaios aleatorizados que indiquen cales pacientes se beneficiarían deste tratamento.
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.
Presentamos un caso de erythema multiforme (EM) oral causado por TMP/SMX, que mostra úlceras bucais e labiais típicas sen lesións cutáneas. Isto subliña a necesidade de diferenciarlo doutros trastornos ulcerativos bucais. O paciente recibiu tratamento sintomático e comprimidos de prednisolona, o que provocou unha mellora despois de interromper a terapia con 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 é unha reacción que implica a pel e, ás veces, as mucosas, desencadeada polo sistema inmunitario. Normalmente, márcase por lesións en forma de diana, que poden aparecer illadas, repetirse ou persistir. Estas lesións adoitan afectar de forma simétrica as extremidades, especialmente as superficies externas. As principais causas inclúen infeccións como o virus do herpes simple e Mycoplasma pneumoniae, así como certos medicamentos, inmunizacións e enfermidades autoinmunes. Distinguir o erythema multiforme da urticaria depende da duración das lesións; as lesións de erythema multiforme permanecen fixas durante polo menos sete días, mentres que as lesións urticáricas adoitan desaparecer nun día. Aínda que son similares, é fundamental diferenciar o erythema multiforme da síndrome de Stevens‑Johnson, máis grave, que normalmente presenta máculas eritematosas ou púrpuras xeneralizadas con burbullas. O tratamento do erythema multiforme consiste en alivio sintomático con esteroides tópicos ou antihistamínicos e en abordar a causa subxacente. Nos casos recorrentes asociados ao virus do herpes simple recoméndase terapia antiviral profiláctica. A afectación grave das mucosas pode requirir hospitalización con fluídos intravenosos e reposición de electrólitos.
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.
A condición varía dende unha erupción cutánea leve e autolimitada ata unha forma grave que ameaza a vida, coñecida como eritema multiforme maior, e que tamén implica as membranas mucosas. A invasión da membrana mucosa ou a presenza de bullas son signos importantes de gravidade.
- Erythema multiforme minor: lesións típicas ou pápulas edematosas elevadas distribuídas acralmente. A forma leve adoita presentar coceira (pode ser moi intensa), manchas rosa‑vermellas, dispostas simétricamente e que comezan nas extremidades. A resolución da erupción cutánea en 7‑10 dias é a norma nesta forma da enfermidade.
- Erythema multiforme major: lesións típicas ou pápulas edematosas elevadas distribuídas acralmente con afectación dunha ou varias mucosas. O desprendemento epidérmico implica menos do 10 % da superficie corporal total.
○ Tratamento – Medicamentos OTC
Se vai acompañada de febre (aumento da temperatura corporal), recoméndase visitar o hospital o antes posible.
As drogas sospeitosas deben interromperse (por exemplo, antibióticos, antiinflamatorios non esteroides).
Antihistamínicos orais como cetirizine e loratadine para a comezón.
#Cetirizine [Zytec]
#LevoCetirizine [Xyzal]
#Loratadine [Claritin]