Erythema multiforme - इरिथेमा मल्टिफॉर्म
☆ जर्मनीबाट 2022 Stiftung Warentest नतिजाहरूमा, ModelDerm सँग उपभोक्ता सन्तुष्टि सशुल्क टेलिमेडिसिन परामर्शको तुलनामा थोरै मात्र थियो।
Erythema multiforme minor ― ध्यान दिनुहोस् कि घावको केन्द्रहरू ब्ल्याच हुन सक्छ।
Urticaria लाई विभेदक निदानको रूपमा पनि मान्न सकिन्छ।
References
Erythema multiforme (EM) प्रतिरक्षा प्रतिक्रियाको कारण छाला र श्लेष्म झिल्ली दुबैमा विशिष्ट लक्ष्य-जस्तो दागहरू देखा पर्ने अवस्था हो। यद्यपि प्रायः भाइरल संक्रमणहरू, विशेष गरी हर्पेस सिम्प्लेक्स भाइरस (HSV) , वा केही औषधिहरू द्वारा ट्रिगर हुन्छन्, धेरै अवस्थामा कारण अज्ञात रहन्छ। तीव्र EM को उपचार स्टेरोइड वा एन्टिहिस्टामाइन युक्त क्रिमहरू प्रयोग गरेर लक्षणहरू कम गर्नमा केन्द्रित हुन्छ। पुनरावर्ती EM को प्रबन्धन सबै भन्दा प्रभावकारी छ जब प्रत्येक रोगी को लागी अनुकूल छ। प्रारम्भिक दृष्टिकोणहरूमा मौखिक र सामयिक उपचारहरू समावेश छन्। यसमा corticosteroids र antiviral औषधिहरू समावेश छन्। सामयिक उपचारहरूमा बलियो स्टेरोइड क्रीमहरू र प्रभावित श्लेष्म झिल्लीहरूका समाधानहरू हुन्छन्। एन्टिभाइरलहरूप्रति अनुत्तरदायी बिरामीहरूका लागि, दोस्रो-लाइन विकल्पहरूमा प्रतिरक्षा-दमन गर्ने औषधिहरू, एन्टिबायोटिकहरू, एन्थेलमिन्टिक्स र मलेरियाहरू समावेश हुन्छन्।
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
धेरै अवस्थामा, हल्का erythema multiforme 2 देखि 4 हप्ता भित्र आफैं हट्छ। Stevens-Johnson Syndrome, श्लेष्म झिल्लीलाई असर गर्ने गम्भीर अवस्था, 6 हप्ता सम्म रहन सक्छ। स्टेरोइडहरू सामान्यतया हल्का केसहरूको लागि सिफारिस गरिँदैन। स्टेरोइडहरू गम्भीर erythema multiforme को लागि प्रयोग गरिनु पर्छ वा छैन अनिश्चित छ किनभने त्यहाँ कुनै पनि स्पष्ट निष्कर्षहरू छैनन् जुन यस उपचारबाट बच्चाहरूले लाभ उठाउँछन्।
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.
हामी मौखिक erythema multiforme (EM) को कारण TMP/SMX को कारण प्रस्तुत गर्दछौं, छालाको घाउ बिना विशिष्ट मौखिक र ओठ अल्सर देखाउँदै। यसले यसलाई अन्य मौखिक अल्सरेटिभ विकारहरूबाट फरक पार्ने आवश्यकतालाई जोड दिन्छ। रोगीले लक्षणात्मक उपचार र prednisolone ट्याब्लेटहरू प्राप्त गर्यो, जसले TMP/SMX थेरापी बन्द गरेपछि सुधार ल्यायो।
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 छाला र कहिलेकाहीँ म्यूकोसा समावेश गर्ने प्रतिक्रिया हो, प्रतिरक्षा प्रणाली द्वारा ट्रिगर। सामान्यतया, यो लक्ष्य-जस्तै घावको रूपमा प्रकट हुन्छ, जुन पृथक देखिन सक्छ, दोहोरिरहन सक्छ, वा जारी रहन्छ। यी घावहरूले प्राय: सममित रूपमा चराहरूलाई असर गर्छ, विशेष गरी तिनीहरूको बाहिरी सतहहरू। मुख्य कारणहरूमा हर्पेस सिम्प्लेक्स भाइरस र माइकोप्लाज्मा निमोनिया जस्ता संक्रमणहरू, साथै केही औषधिहरू, प्रतिरक्षाहरू र अटोइम्यून रोगहरू समावेश छन्। urticaria बाट erythema multiforme छुट्याउन घावको अवधिमा निर्भर गर्दछ; erythema multiforme घाउहरू कम्तिमा सात दिनको लागि स्थिर रहन्छ, जबकि urticarial घावहरू प्राय: एक दिन भित्र हराउँछन्। यद्यपि समान रूपमा, यो अधिक गम्भीर Stevens-Johnson सिन्ड्रोम बाट erythema multiforme फरक गर्न महत्त्वपूर्ण छ, जसले सामान्यतया व्यापक एरिथेमेटस वा पर्प्युरिक म्याक्युलहरू ब्लिस्टरहरू प्रस्तुत गर्दछ। erythema multiforme व्यवस्थापनमा सामयिक स्टेरोइड वा एन्टिहिस्टामाइनहरू र अन्तर्निहित कारणलाई सम्बोधन गर्ने लक्षणात्मक राहत समावेश छ। हर्पेस सिम्प्लेक्स भाइरससँग सम्बन्धित पुनरावर्ती केसहरूको लागि, प्रोफिलेक्टिक एन्टिभाइरल थेरापी सिफारिस गरिन्छ। गम्भीर म्यूकोसल संलग्नताले नसामा तरल पदार्थ र इलेक्ट्रोलाइट प्रतिस्थापनको लागि अस्पताल भर्ना हुन सक्छ।
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.
यो अवस्था हल्का, आत्म-सीमित दाना देखि एक गम्भीर, जीवन-धम्की दिने ढाँचामा erythema multiforme major भनिन्छ जसमा श्लेष्म झिल्लीहरू पनि समावेश हुन्छन्। श्लेष्म झिल्लीको आक्रमण वा बुलेजको उपस्थिति गम्भीरताका महत्त्वपूर्ण संकेतहरू हुन्।
- Erythema multiforme minor: विशिष्ट लक्ष्य वा उठाइएको, edematous papules acrally वितरित
हल्का रूप सामान्यतया हल्का खुजली (तर चिलाउने धेरै गम्भीर हुन सक्छ), गुलाबी-रातो धब्बा, सममित रूपमा व्यवस्थित र चट्टानहरूमा सुरु हुन्छ। 7-10 दिन भित्र दाना को समाधान रोग को यो रूप मा सामान्य हो।
- Erythema multiforme major: एक वा बढी श्लेष्म झिल्लीको संलग्नताको साथ एक्रोली रूपमा वितरित विशिष्ट लक्ष्यहरू वा उठाइएको, एडेमेटस प्यापुल्स। एपिडर्मल डिटेचमेन्टले कुल शरीरको सतह क्षेत्रको १०% भन्दा कम समावेश गर्दछ।
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