Erythema multiforme - Ko'P Shaklli Eritema
☆ Germaniyaning 2022 yilgi Stiftung Warentest natijalariga ko'ra, iste'molchilarning ModelDermdan qoniqish darajasi pullik teletibbiyot maslahatlariga qaraganda bir oz pastroq bo'lgan.
Erythema multiforme minor ― E'tibor bering, lezyonlarning markazlari oqarib ketishi mumkin.
Urticaria differentsial tashxis sifatida ham ko'rib chiqilishi mumkin.
References
Erythema multiforme (EM) - immunitet reaktsiyalari tufayli terida ham, shilliq pardalarda ham nishonga o'xshash o'ziga xos dog'lar paydo bo'ladigan holat. Ko'pincha virusli infektsiyalar, ayniqsa gerpes simplex virusi (HSV) yoki ba'zi dorilar tomonidan qo'zg'atilgan bo'lsa-da, ko'p hollarda sabab noma'lum bo'lib qolmoqda. O'tkir EMni davolashda steroidlar yoki antigistaminlarni o'z ichiga olgan kremlar yordamida simptomlarni engillashtirishga qaratilgan. Takroriy EMni boshqarish har bir bemorga moslashtirilganda eng samarali hisoblanadi. Dastlabki yondashuvlar og'zaki va topikal davolanishni o'z ichiga oladi. Bularga kortikosteroidlar va antiviral preparatlar kiradi. Mahalliy davolanish kuchli steroid kremlari va ta'sirlangan shilliq pardalar uchun eritmalardan iborat. Antiviral vositalarga javob bermaydigan bemorlar uchun ikkinchi darajali variantlarga immunitetni susaytiruvchi dorilar, antibiotiklar, antigelmintiklar va antimalarial dorilar kiradi.
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
Ko'pgina hollarda, engil erythema multiforme 2-4 hafta ichida o'z-o'zidan yo'qoladi. Stivens-Jonson sindromi, shilliq qavatlarga ta'sir qiluvchi og'ir holat, 6 haftagacha davom etishi mumkin. Ukol odatda engil holatlar uchun tavsiya etilmaydi. Og'ir eritema multiforme uchun steroidlarni qo'llash kerakmi yoki yo'qmi, noaniq, chunki randomizatsiyalangan tadqiqotlarda qaysi bolalar ushbu davolashdan foyda olishini ko'rsatadigan aniq natijalar yo'q.
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.
Biz og'iz bo'shlig'i erythema multiforme (EM) TMP/SMX tufayli kelib chiqqan, teri jarohatlarisiz og'iz bo'shlig'i va lablar yaralarini ko'rsatamiz. Bu uni boshqa og'iz yarasi kasalliklaridan farqlash zarurligini ta'kidlaydi. Bemorga simptomatik davolash va prednizolon tabletkalari berildi, bu TMP/SMX terapiyasini to'xtatgandan keyin yaxshilanishga olib keldi.
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 - bu immunitet tizimi tomonidan qo'zg'atilgan teri va ba'zan shilliq qavatdagi reaktsiya. Odatda, u nishonga o'xshash lezyonlar sifatida namoyon bo'ladi, ular izolyatsiya qilingan ko'rinishi, takrorlanishi yoki davom etishi mumkin. Ushbu jarohatlar odatda nosimmetrik tarzda ekstremitalarga, ayniqsa ularning tashqi yuzalariga ta'sir qiladi. Asosiy sabablarga gerpes simplex virusi va Mycoplasma pneumoniae kabi infektsiyalar, shuningdek, ba'zi dorilar, immunizatsiya va otoimmün kasalliklar kiradi. Erythema multiforme ni ürtikerdan ajratish lezyonlarning davomiyligiga tayanadi; erythema multiforme lezyonlar kamida etti kun davomida barqaror bo'lib qoladi, ürtiker lezyonlar ko'pincha bir kun ichida yo'qoladi. Shunga o'xshash bo'lsa-da, erythema multiforme ni og'irroq Stivens-Jonson sindromidan farqlash juda muhim, bu odatda keng tarqalgan eritematoz yoki pufakchali dog'lar bilan namoyon bo'ladi. Erythema multiforme boshqaruvi topikal steroidlar yoki antigistaminlar bilan simptomatik yengillikni va asosiy sababni bartaraf etishni o'z ichiga oladi. Herpes simplex virusi bilan bog'liq takroriy holatlar uchun profilaktik antiviral terapiya tavsiya etiladi. Shilliq qavatning og'ir shikastlanishi tomir ichiga suyuqlik yuborish va elektrolitlarni almashtirish uchun kasalxonaga yotqizishni talab qilishi mumkin.
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.
Vaziyat engil, o'z-o'zidan cheklangan toshmalardan shilliq qavatlarni ham qamrab oladigan eritema ko'p shaklli deb ataladigan og'ir, hayot uchun xavfli shaklgacha o'zgaradi. Shilliq qavatning invaziyasi yoki buqalarning mavjudligi jiddiylikning muhim belgilaridir.
- Erythema multiforme minor: tipik nishonlar yoki ko'tarilgan, akral tarzda tarqalgan shish papulalar
Engil shakl odatda engil qichishish (lekin qichishish juda kuchli bo'lishi mumkin), nosimmetrik tarzda joylashgan va ekstremitalardan boshlanadigan pushti-qizil dog'lar bilan namoyon bo'ladi. 7-10 kun ichida toshmalarni bartaraf etish kasallikning ushbu shaklida norma hisoblanadi.
- Erythema multiforme major: tipik nishonlar yoki ko'tarilgan, shishgan papulalar, bir yoki bir nechta shilliq pardalar ishtirokida akral tarzda taqsimlanadi. Epidermisning ajralishi tananing umumiy yuzasining 10% dan kamrog'ini o'z ichiga oladi.
○ Davolash ― OTC dori vositalari
Agar isitma (tana haroratining ko'tarilishi) bilan birga bo'lsa, kasalxonaga imkon qadar tezroq tashrif buyurish tavsiya etiladi.
Shubhali dorilarni qabul qilishni to'xtatish kerak. (masalan, antibiotiklar, steroid bo'lmagan yallig'lanishga qarshi dorilar)
Qichishish uchun setirizin va loratadin kabi og'iz antigistaminlari.
#Cetirizine [Zytec]
#LevoCetirizine [Xyzal]
#Loratadine [Claritin]