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.
relevance score : -100.0%
ReferencesErythema multiforme (EM) adalah kondisi di mana bintik‑bintik khas berbentuk target muncul pada kulit dan selaput lendir akibat reaksi imun. Meskipun sering dipicu oleh infeksi virus, terutama virus herpes simpleks (HSV), atau oleh obat‑obatan tertentu, dalam banyak kasus penyebabnya masih belum diketahui. Pengobatan EM akut berfokus pada meringankan gejala dengan menggunakan krim yang mengandung steroid atau antihistamin. Penatalaksanaan EM berulang paling efektif bila disesuaikan dengan masing‑masing pasien. Pendekatan awal meliputi terapi oral dan topikal, termasuk kortikosteroid dan obat antivirus. Terapi topikal terdiri dari krim steroid kuat serta larutan untuk selaput lendir yang terlibat. Pada pasien yang tidak merespon obat antivirus, pilihan lini kedua mencakup agen imunosupresif, antibiotik, obat antihelmintik, 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 (eritema multiforme) ringan akan hilang dengan sendirinya dalam waktu 2 hingga 4 minggu. Stevens‑Johnson syndrome (Sindrom Stevens‑Johnson), suatu kondisi parah yang mempengaruhi selaput lendir, dapat berlangsung hingga 6 minggu. Steroid biasanya tidak direkomendasikan untuk kasus ringan. Apakah steroid harus digunakan untuk erythema multiforme (eritema multiforme) yang parah masih belum pasti karena belum ada temuan yang jelas dari penelitian acak terkontrol yang menunjukkan pasien 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 pentingnya membedakannya dari gangguan ulseratif mulut lainnya. Pasien menerima pengobatan simptomatik dan tablet prednisolon, yang menunjukkan perbaikan setelah penghentian 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 berbentuk target, yang dapat tampak terisolasi, berulang, atau menetap. Lesi ini biasanya menyerang ekstremitas secara simetris, terutama pada permukaan luar. Penyebab utamanya meliputi 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; pada erythema multiforme lesi tetap setidaknya tujuh hari, sedangkan lesi urtikaria biasanya hilang dalam satu hari. Meskipun serupa, penting untuk membedakan erythema multiforme dari sindrom Stevens‑Johnson yang lebih parah, yang biasanya ditandai oleh makula eritematosa atau purpura luas disertai lepuh. Penanganan erythema multiforme meliputi pengurangan gejala dengan steroid topikal atau antihistamin serta mengatasi penyebab utama. Untuk kasus berulang yang berhubungan dengan virus herpes simpleks, terapi antiviral profilaksis dianjurkan. Keterlibatan mukosa yang parah mungkin memerlukan rawat inap untuk pemberian 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 ringan yang dapat sembuh hingga bentuk yang parah dan mengancam jiwa, yang dikenal sebagai eritema multiforme mayor dan melibatkan selaput lendir. Invasi selaput lendir atau adanya bula merupakan tanda penting keparahan penyakit.
- Erythema multiforme minor: lesi target khas, papula edematous yang tersebar secara akral. Bentuk ringan biasanya muncul dengan gatal ringan (meskipun gatal dapat menjadi sangat parah), bercak merah‑jambu, berdistribusi simetris, dan dimulai pada ekstremitas. Resolusi ruam dalam 7‑10 hari merupakan hal yang normal pada bentuk penyakit ini.
- Erythema multiforme major: lesi target khas atau menonjol, papula edematous 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 segera mengunjungi rumah sakit.
Obat‑obatan yang dicurigai harus dihentikan (misalnya antibiotik, NSAIDs (obat antiinflamasi nonsteroid)).
Antihistamin oral seperti cetirizine atau loratadine dapat diberikan untuk mengatasi gatal.
#Cetirizine [Zytec]
#LevoCetirizine [Xyzal]
#Loratadine [Claritin]