Erythema multiforme - Eritema Multiforme
☆ Pada hasil Stiftung Warentest tahun 2022 dari Jerman, kepuasan konsumen terhadap ModelDerm hanya sedikit lebih rendah dibandingkan dengan konsultasi telemedis berbayar.
Erythema multiforme minor ― Perhatikan bahwa bagian tengah lesi mungkin pucat.
Urtikaria juga dapat dianggap sebagai diagnosis banding.
References
Erythema multiforme (EM) adalah suatu kondisi di mana bintik-bintik khas seperti sasaran muncul pada kulit dan selaput lendir akibat reaksi imun. Meski sering dipicu oleh infeksi virus, terutama virus herpes simpleks (HSV) , atau obat-obatan tertentu, dalam banyak kasus penyebabnya masih belum diketahui. Mengobati EM akut berfokus pada meringankan gejala dengan menggunakan krim yang mengandung steroid atau antihistamin. Mengelola EM berulang paling efektif jika disesuaikan dengan masing-masing pasien. Pendekatan awal melibatkan perawatan oral dan topikal. Ini termasuk kortikosteroid dan obat antivirus. Perawatan topikal terdiri dari krim steroid yang kuat dan larutan untuk selaput lendir yang terkena. Untuk pasien yang tidak responsif terhadap obat antivirus, pilihan lini kedua mencakup obat penekan kekebalan, antibiotik, obat cacing, dan antimalaria.
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
Dalam banyak kasus, erythema multiforme ringan akan hilang dengan sendirinya dalam waktu 2 hingga 4 minggu. Sindrom Stevens-Johnson, suatu kondisi parah yang mempengaruhi selaput lendir, dapat berlangsung hingga 6 minggu. Steroid biasanya tidak direkomendasikan untuk kasus-kasus ringan. Apakah steroid harus digunakan untuk eritema multiforme yang parah masih belum pasti karena tidak ada temuan yang jelas dari penelitian acak yang menunjukkan anak mana yang akan mendapat manfaat dari pengobatan ini.
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.
Kami menyajikan kasus erythema multiforme (EM) mulut yang disebabkan oleh TMP/SMX , menunjukkan ulkus mulut dan bibir yang khas tanpa lesi kulit. Hal ini menggarisbawahi kebutuhan untuk membedakannya dari gangguan ulseratif mulut lainnya. Pasien menerima pengobatan simtomatik dan tablet prednisolon, yang menunjukkan perbaikan setelah menghentikan terapi 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 adalah reaksi yang melibatkan kulit dan terkadang mukosa, dipicu oleh sistem kekebalan tubuh. Biasanya, penyakit ini bermanifestasi sebagai lesi seperti target, yang mungkin tampak terisolasi, berulang, atau menetap. Lesi ini biasanya menyerang ekstremitas secara simetris, khususnya permukaan luarnya. Penyebab utamanya termasuk infeksi seperti virus herpes simpleks dan Mycoplasma pneumoniae, serta obat-obatan tertentu, imunisasi, dan penyakit autoimun. Membedakan erythema multiforme dari urtikaria bergantung pada durasi lesi; erythema multiforme lesi tetap menetap setidaknya selama tujuh hari, sedangkan lesi urtikaria sering kali hilang dalam satu hari. Meskipun serupa, penting untuk membedakan erythema multiforme dari sindrom Stevens-Johnson yang lebih parah, yang biasanya menunjukkan makula eritematosa atau purpura yang luas disertai lepuh. Penanganan erythema multiforme melibatkan pengurangan gejala dengan steroid topikal atau antihistamin dan mengatasi penyebab utamanya. Untuk kasus berulang yang berhubungan dengan virus herpes simpleks, terapi antiviral profilaksis dianjurkan. Keterlibatan mukosa yang parah mungkin memerlukan rawat inap untuk penggantian cairan intravena dan elektrolit.
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.
Kondisi ini bervariasi dari ruam yang ringan dan dapat disembuhkan hingga bentuk yang parah dan mengancam jiwa yang dikenal sebagai eritema multiforme mayor yang juga melibatkan selaput lendir. Invasi selaput lendir atau adanya bula merupakan tanda penting keparahan penyakit.
- Erythema multiforme minor: target yang khas atau timbul, papula edema yang tersebar secara akral
Bentuk ringan biasanya muncul dengan rasa gatal ringan (tetapi gatal bisa sangat parah), bercak merah jambu-merah, tersusun simetris dan dimulai pada ekstremitas. Resolusi ruam dalam waktu 7-10 hari adalah hal yang normal pada bentuk penyakit ini.
- Erythema multiforme major: sasaran yang khas atau menonjol, papula edema yang tersebar secara akral dengan melibatkan satu atau lebih selaput lendir. Detasemen epidermis melibatkan kurang dari 10% total luas permukaan tubuh.
○ Pengobatan - Obat OTC
Jika disertai demam (peningkatan suhu tubuh), disarankan untuk segera mengunjungi rumah sakit.
Obat-obatan yang dicurigai harus dihentikan. (misalnya antibiotik, obat antiinflamasi nonsteroid)
Antihistamin oral seperti cetirizine dan loratadine untuk mengatasi gatal.
#Cetirizine [Zytec]
#LevoCetirizine [Xyzal]
#Loratadine [Claritin]