Erythema multiforme - Multiformni Eritem
☆ V rezultatih raziskave Stiftung Warentest iz Nemčije leta 2022 je bilo zadovoljstvo potrošnikov z ModelDermom le nekoliko nižje kot s plačanimi telemedicinskimi svetovanji.
Erythema multiforme minor ― Upoštevajte, da lahko središča lezij zbledijo.
Urtikarijo lahko obravnavamo tudi kot diferencialno diagnozo.
References
Erythema multiforme (EM) je stanje, pri katerem se zaradi imunskih reakcij na koži in sluznicah pojavijo značilne lise, podobne tarči. Čeprav ga pogosto sprožijo virusne okužbe, zlasti virus herpes simplex (HSV) , ali nekatera zdravila, vzrok v mnogih primerih ostaja neznan. Zdravljenje akutne EM se osredotoča na lajšanje simptomov z uporabo krem, ki vsebujejo steroide ali antihistaminike. Obvladovanje ponavljajočih se EM je najučinkovitejše, če je prilagojeno posameznemu bolniku. Začetni pristopi vključujejo tako peroralno kot lokalno zdravljenje. Sem spadajo kortikosteroidi in protivirusna zdravila. Lokalno zdravljenje je sestavljeno iz močnih steroidnih krem in raztopin za prizadete sluznice. Za bolnike, ki se ne odzivajo na protivirusna zdravila, so možnosti druge izbire zdravila za zaviranje imunskega sistema, antibiotiki, anthelmintiki in antimalariki.
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
V mnogih primerih blago erythema multiforme izgine samo od sebe v 2 do 4 tednih. Stevens-Johnsonov sindrom, hudo stanje, ki prizadene sluznice, lahko traja do 6 tednov. Steroidi se običajno ne priporočajo za blage primere. Negotovo je, ali je treba steroide uporabljati pri hudem multiformnem eritemu, saj ni jasnih ugotovitev iz randomiziranih študij, ki bi pokazale, katerim otrokom bi to zdravljenje koristilo.
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.
Predstavljamo primer oralne erythema multiforme (EM) , ki jo povzroča TMP/SMX , ki kaže tipične razjede v ustih in ustnicah brez kožnih lezij. To poudarja potrebo po razlikovanju od drugih oralnih razjed. Bolnik je prejel simptomatsko zdravljenje in tablete prednizolona, kar je vodilo do izboljšanja po prekinitvi zdravljenja s 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 je reakcija, ki vključuje kožo in včasih sluznico, ki jo sproži imunski sistem. Običajno se kaže kot tarči podobne lezije, ki so lahko videti izolirane, se ponavljajo ali vztrajajo. Te lezije običajno simetrično prizadenejo okončine, zlasti njihove zunanje površine. Glavni vzroki vključujejo okužbe, kot sta virus herpes simplex in Mycoplasma pneumoniae, pa tudi nekatera zdravila, imunizacije in avtoimunske bolezni. Razlikovanje erythema multiforme od urtikarije je odvisno od trajanja lezij; erythema multiforme lezije ostanejo pritrjene vsaj sedem dni, medtem ko urtikarijske lezije pogosto izginejo v enem dnevu. Čeprav je podoben, je ključnega pomena razlikovati erythema multiforme od hujšega Stevens-Johnsonovega sindroma, ki običajno predstavlja razširjene eritematozne ali purpurne pege z mehurji. Obvladovanje erythema multiforme vključuje simptomatsko lajšanje z lokalnimi steroidi ali antihistaminiki in obravnavanje osnovnega vzroka. Pri ponavljajočih se primerih, povezanih z virusom herpes simplex, se priporoča profilaktično protivirusno zdravljenje. Huda prizadetost sluznice lahko zahteva hospitalizacijo zaradi intravenskih tekočin in nadomeščanja elektrolitov.
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.
Stanje se razlikuje od blagega, samoomejenega izpuščaja do hude, smrtno nevarne oblike, znane kot multiformni eritem, ki vključuje tudi sluznice. Invazija sluznice ali prisotnost bul sta pomembna znaka resnosti.
- Erythema multiforme minor: tipične tarče ali dvignjene, edematozne papule, porazdeljene akralno
Blaga oblika se običajno kaže z rahlo srbečimi (vendar je srbenje lahko zelo hudo), rožnato rdečimi madeži, ki so simetrično razporejeni in se začnejo na okončinah. Rešitev izpuščaja v 7-10 dneh je norma pri tej obliki bolezni.
- Erythema multiforme major: tipične tarče ali dvignjene, edematozne papule, porazdeljene akralno s prizadetostjo ene ali več sluznic. Odstop povrhnjice zajema manj kot 10 % celotne telesne površine.
○ Zdravljenje ― OTC zdravila
Če ga spremlja vročina (naraščajoča telesna temperatura), je priporočljivo čim prej obiskati bolnišnico.
Sumljiva zdravila je treba opustiti. (npr. antibiotiki, nesteroidna protivnetna zdravila)
Peroralni antihistaminiki, kot sta cetirizin in loratadin za srbenje.
#Cetirizine [Zytec]
#LevoCetirizine [Xyzal]
#Loratadine [Claritin]