Erythema multiforme - 多形红斑
Erythema multiforme minor ― 请注意，病变中心可能出现白斑。
荨麻疹也可作为鉴别诊断。
relevance score : -100.0%
ReferencesErythema multiforme (EM) 是一种因免疫反应而在皮肤和粘膜出现特征性靶状斑点的疾病。虽然多数病例由病毒感染（尤其是单纯疱疹病毒 (HSV)）或某些药物诱发，但在许多情况下仍找不到明确原因。治疗急性 EM 的重点是使用含类固醇或抗组胺药的乳膏来缓解症状。针对每位患者量身定制的复发性 EM 治疗方案最为有效。首选治疗包括口服和局部用药，常用药物有皮质类固醇和抗病毒药物。局部治疗可采用强效类固醇乳膏以及用于受累粘膜的溶液。对于对抗病毒药物无反应的患者，二线方案包括免疫抑制剂、抗生素、驱虫药和抗疟药。
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
在多数情况下，轻度 erythema multiforme（多形性红斑）会在 2 至 4 周内自行消退。史蒂文斯-约翰逊综合征是一种累及粘膜的严重疾病，病程可长达 6 周。对于轻度病例，通常不建议使用类固醇。对于严重的多形红斑是否应使用类固醇仍不确定，因为随机研究尚未明确哪些儿童能够从该治疗中获益。
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.
我们介绍一例因 TMP/SMX 引发的口腔 erythema multiforme (EM) 病例，表现为典型的口腔和唇部溃疡，未出现皮肤损害。这提醒我们在临床上需要将其与其他口腔溃疡性疾病加以区分。患者接受对症治疗并口服泼尼松龙片，停用 TMP/SMX 后病情逐渐好转。
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 是一种涉及皮肤、偶尔也涉及黏膜的免疫介导性反应。它通常表现为靶形病变，可为单发、复发或持续存在。病变常对称分布于四肢，尤其是外侧表面。主要诱因包括单纯疱疹病毒、肺炎支原体等感染，以及某些药物、免疫接种和自身免疫性疾病。Erythema multiforme 与荨麻疹的区别在于病变持续时间；Erythema multiforme 病变至少固定 7 天，而荨麻疹病变通常在一天内消退。尽管两者相似，但必须将 Erythema multiforme 与更严重的史蒂文斯-约翰逊综合征区分开来，后者常表现为广泛的红斑或紫癜并伴有水疱。Erythema multiforme 的治疗包括局部使用类固醇或抗组胺药以缓解症状，并针对根本原因进行处理。对于与单纯疱疹病毒相关的复发病例，建议预防性抗病毒治疗。严重黏膜受累时可能需要住院，进行静脉输液和电解质补充。
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.
病情范围从轻微的自限性皮疹到严重的危及生命的多形性红斑（可累及粘膜）不等。粘膜受累或出现大疱是严重程度的重要标志。
- Erythema multiforme minor：典型的目标样或分布于肢端的凸起、水肿性丘疹。轻度形式通常伴有轻度瘙痒（但有时瘙痒可非常严重），呈粉红色斑点，对称分布，起始于四肢。该类型的皮疹一般在 7–10 天内自行消退。
- Erythema multiforme major：典型的目标样或凸起、水肿性丘疹，分布于肢端，累及一层或多层粘膜。表皮脱落涉及的体表面积不超过 10%。
○ 治疗 - 非处方药
如伴有发热（体温升高），应尽快就医。可疑药物应停用（如抗生素、非甾体抗炎药）。口服抗组胺药可缓解瘙痒，例如西替利嗪和氯雷他定。
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