Erythema multiformehttps://en.wikipedia.org/wiki/Erythema_multiforme
Erythema multiforme ni hali ya ngozi inayoonekana ikiwa na mabaka mekundu yanayobadilika na kuwa “lesioni za lengo (target lesions)” (kawaida kidonda kiko kwenye mikono yote miwili). Ni aina ya erythema ambayo inaweza kusababisha na maambukizi au yatokanayo na dawa. Hali hii hutofautiana kutoka kwa upele mdogo na usio na kikomo hadi fomu kali ya kutishia maisha inayojulikana kama erythema multiforme major ambayo pia inahusisha membrani ya mkojo (mucous membranes). Uvamizi wa membrani ya mkojo au uwepo wa bulla ni ishara muhimu za ukali.

- Erythema multiforme minor: lesioni za kawaida au zilizoinuliwa, papuli zenye edema zinazosambazwa kwa haraka. Aina ya upole kawaida hujidhihirisha na ina kuwasha kidogo (lakini kuwasha kunaweza kuwa kali sana), madoa mekundu‑waridi, yaliyopangwa kwa ulinganifu na kuanzia kwenye ncha. Kupungua kwa upele ndani ya siku 7‑10 ni kawaida katika aina hii ya ugonjwa huo.

- Erythema multiforme major: lesioni za kawaida au zilizoinuliwa, papuli zenye edema zinazosambazwa kwa haraka kwa kuhusisha membrani ya mkojo mmoja au zaidi. Ukunja wa epidermis kinahusisha chini ya 10 % ya jumla ya eneo la uso wa mwili.

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  • Erythema multiforme minor ― Kumbuka kwamba maeneo ya vidonda yanaweza kuwa meupe.
  • Vidonda vya lengo kwenye mguu
  • Urticaria inaweza pia kuzingatiwa kama utambuzi tofauti.
  • Kidonda lengwa la Erythema multiforme ― Inaweza pia kuwa dalili ya mapema ya TEN, ambayo husababisha malengelenge yaliyoenea.
  • Onyesho la kawaida la Erythema multiforme
  • Lyme disease (Ugonjwa wa Lyme) unapaswa pia kuzingatiwa. cf) Bulls eye of Lyme Disease Rash
References Recent Updates in the Treatment of Erythema Multiforme 34577844 
NIH
Erythema multiforme (EM) ni hali ambapo madoa mahususi yanayofanana na lesioni za lengo yanaonekana kwenye ngozi na utando wa mdomo (mucous membranes) kutokana na athari za kinga. Ingawa mara nyingi husababishwa na maambukizi ya virusi, hasa virusi vya herpes simplex (HSV), au dawa fulani, sababu bado haijulikani katika matukio mengi. Kutibu EM ya papo hapo hulenga katika kupunguza dalili kwa kutumia krimu zilizo na steroids au antihistamines. Kusimamia EM inayojirudia ni bora zaidi inapoundwa kwa kila mgonjwa. Matibabu ya awali yanahusisha matibabu ya mdomo na ya juu. Hizi ni pamoja na corticosteroids na dawa za kuzuia virusi. Matibabu ya juu yanajumuisha creams kali za steroid na ufumbuzi kwa utando wa mdomo walioathirika. Kwa wagonjwa wasioitikia dawa za kuzuia virusi, chaguo la pili ni pamoja na dawa za kukandamiza kinga, viua vijasumu (antibiotics), dawa za anthelmintiki, na dawa ya kupambana na malaria (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
 Use of steroids for erythema multiforme in children 16353829 
NIH
Katika hali nyingi, erythema multiforme kidogo huenda yenyewe ndani ya wiki 2 hadi 4. Ugonjwa wa Stevens-Johnson, hali mbaya inayoathiri utando wa mucous, inaweza kudumu hadi wiki 6. Dawa za steroids kwa kawaida hazipendekezwi kwa kesi zisizo kali. Ikiwa steroids inapaswa kutumika kwa erythema multiforme kali haijulikani kwa kuwa hakuna matokeo ya wazi kutoka kwa tafiti zisizo na mpangilio zinazoonyesha ni watoto gani wangefaidika na matibabu haya.
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.
 Drug-induced Oral Erythema Multiforme: A Diagnostic Challenge 29363636 
NIH
Tunawasilisha kesi ya erythema multiforme (EM) ya mdomo inayosababishwa na TMP/SMX, inayoonyesha vidonda vya kawaida vya mdomo na midomo bila vidonda vya ngozi. Hii inasisitiza haja ya kuitofautisha na magonjwa mengine ya vidonda vya mdomo. Mgonjwa alipata matibabu ya dalili na vidonge vya prednisolone, na kusababisha uboreshaji baada ya kuacha tiba ya 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.
 Erythema Multiforme: Recognition and Management. 31305041
Erythema multiforme ni mmenyuko unaohusisha ngozi na wakati mwingine mucosa, unaosababishwa na mfumo wa kinga. Kwa kawaida, hujidhihirisha kama vidonda vinavyolengwa, ambavyo vinaweza kuonekana kutengwa, kujirudia au kudumu. Vidonda hivi kawaida huathiri viungo vya mwili, hasa sehemu za nje. Sababu kuu ni pamoja na maambukizi kama vile virusi vya herpes simplex na Mycoplasma pneumoniae, pamoja na baadhi ya dawa, chanjo, na magonjwa ya autoimmune. Kutofautisha erythema multiforme kutoka kwa urticaria inategemea muda wa vidonda; vidonda erythema multiforme husalia imara kwa angalau siku saba, wakati vidonda vya urticaria mara nyingi hupotea ndani ya siku. Ingawa zinafanana, ni muhimu kutofautisha erythema multiforme na ugonjwa mbaya zaidi wa Stevens‑Johnson, ambao kwa kawaida hutoa malengelenge ya erythematous au purpuric yaliyoenea. Kudhibiti erythema multiforme kunahusisha kupunguza dalili na dawa za steroid za juu ya ngozi au antihistamini na kushughulikia sababu kuu. Kwa matukio ya mara kwa mara yanayohusiana na virusi vya herpes simplex, tiba ya antiviral ya prophylactic inapendekezwa. Kuhusika sana kwa mucosa kunaweza kuhitaji kulazwa hospitalini kwa mifumo ya mishipa na uingizwaji wa elektroliti.
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.