Erythema multiforme - Eritema Multiforme
☆ Fir-riżultati ta' Stiftung Warentest tal-2022 mill-Ġermanja, is-sodisfazzjon tal-konsumatur b'ModelDerm kien biss ftit inqas milli b'konsultazzjonijiet bit-telemediċina mħallsa.
Erythema multiforme minor ― Innota li ċ-ċentri tal-leżjonijiet jistgħu jbajdu.
Urtikarja tista 'wkoll titqies bħala dijanjosi differenzjali.
References
Erythema multiforme (EM) hija kundizzjoni fejn tikek distintivi bħal mira jidhru kemm fuq il-ġilda kif ukoll fuq il-membrani mukużi minħabba reazzjonijiet immuni. Għalkemm ħafna drabi kkawżati minn infezzjonijiet virali, speċjalment virus herpes simplex (HSV) , jew ċerti mediċini, il-kawża tibqa 'mhux magħrufa f'ħafna każijiet. It-trattament ta 'EM akut jiffoka fuq it-taffija tas-sintomi bl-użu ta' kremi li fihom sterojdi jew antistaminiċi. Il-ġestjoni tal-EM rikorrenti hija l-aktar effettiva meta tkun imfassla għal kull pazjent. L-approċċi inizjali jinvolvu kemm trattamenti orali kif ukoll topiċi. Dawn jinkludu kortikosterojdi u mediċini antivirali. Trattamenti topiċi jikkonsistu fi kremi sterojdi qawwija u soluzzjonijiet għall-membrani mukużi affettwati. Għal pazjenti li ma jirrispondux għall-antivirali, l-għażliet tat-tieni linja jinkludu mediċini li jrażżnu l-immunità, antibijotiċi, antihelmintiċi u antimalarja.
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
F'ħafna każijiet, erythema multiforme ħafif imur waħdu fi żmien 2 sa 4 ġimgħat. Is-sindromu ta’ Stevens-Johnson, kundizzjoni severa li taffettwa l-membrani mukużi, jista’ jdum sa 6 ġimgħat. L-isterojdi mhumiex tipikament rakkomandati għal każijiet ħfief. Mhux ċert jekk l-isterojdi għandhomx jintużaw għal eritema multiforme severa peress li m'hemm l-ebda sejbiet ċari minn studji randomised li jindikaw liema tfal jibbenefikaw minn din il-kura.
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.
Nippreżentaw każ ta' erythema multiforme (EM) orali ikkawżat minn TMP/SMX , li juri ulċeri tipiċi tal-ħalq u tax-xufftejn mingħajr feriti fil-ġilda. Dan jenfasizza l-ħtieġa li jiġi differenzjat minn disturbi ulċerattivi orali oħra. Il-pazjent irċieva trattament sintomatiku u pilloli prednisolone, li wasslu għal titjib wara li waqqaf it-terapija 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 hija reazzjoni li tinvolvi l-ġilda u xi drabi l-mukoża, ikkawżata mis-sistema immuni. Tipikament, jimmanifesta bħala leżjonijiet bħal mira, li jistgħu jidhru iżolati, jerġgħu jseħħu, jew jippersistu. Dawn il-leżjonijiet ġeneralment jaffettwaw b'mod simmetriku l-estremitajiet, partikolarment l-uċuħ ta 'barra tagħhom. Il-kawżi ewlenin jinkludu infezzjonijiet bħall-virus tal-herpes simplex u Mycoplasma pneumoniae, kif ukoll ċerti mediċini, tilqim, u mard awtoimmuni. Id-distinzjoni erythema multiforme minn urtikarja tiddependi fuq it-tul tal-leżjonijiet; erythema multiforme il-leżjonijiet jibqgħu fissi għal mill-inqas sebat ijiem, filwaqt li l-leżjonijiet urtikarja ħafna drabi jgħibu fi żmien ġurnata. Għalkemm simili, huwa kruċjali li ssir differenza erythema multiforme mis-sindromu Stevens-Johnson aktar sever, li tipikament jippreżenta makuli eritematożi jew purpuriċi mifruxa b'folji. Il-ġestjoni erythema multiforme tinvolvi serħan sintomatiku bi sterojdi topiċi jew anti-istaminiċi u tindirizza l-kawża sottostanti. Għal każijiet rikorrenti assoċjati mal-virus herpes simplex, terapija antivirali profilattika hija rakkomandata. Involviment sever tal-mukuża jista' jeħtieġ dħul fl-isptar għal fluwidi ġol-vini u sostituzzjoni tal-elettroliti.
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.
Il-kundizzjoni tvarja minn raxx ħafif u awtolimitat għal forma severa u ta’ theddida għall-ħajja magħrufa bħala eritema multiforme maġġuri li tinvolvi wkoll membrani mukużi. L-invażjoni tal-membrana mukuża jew il-preżenza ta 'bulaes huma sinjali importanti ta' severità.
- Erythema multiforme minor: miri tipiċi jew papules mgħollija, edematożi mqassma b'mod akral
Il-forma ħafifa ġeneralment tippreżenta ħakk ħafif (iżda ħakk jista 'jkun qawwi ħafna), blotches roża-aħmar, rranġati b'mod simetriku u li jibdew fuq l-estremitajiet. Ir-riżoluzzjoni tar-raxx fi żmien 7-10 ijiem hija n-norma f'din il-forma tal-marda.
- Erythema multiforme major: miri tipiċi jew papules mgħollija u edematożi mqassma b'mod akral b'involviment ta' membrani mukużi waħda jew aktar. Id-distakk epidermali jinvolvi inqas minn 10% tal-erja totali tal-wiċċ tal-ġisem.
○ Trattament - Drogi OTC
Jekk ikun akkumpanjat minn deni (żieda fit-temperatura tal-ġisem), huwa rakkomandat li żżur l-isptar kemm jista 'jkun malajr.
Drogi suspettati għandhom jitwaqqfu. (eż. antibijotiċi, mediċini anti-infjammatorji mhux sterojdi)
Anti-istaminiċi orali bħal cetirizine u loratadine għall-ħakk.
#Cetirizine [Zytec]
#LevoCetirizine [Xyzal]
#Loratadine [Claritin]