Erythema multiforme - 多形红斑
Erythema multiforme minor ― 请注意，病变中心可能会变白。
荨麻疹也可被视为鉴别诊断。
relevance score : -100.0%
ReferencesErythema multiforme (EM) 是一种因免疫反应导致皮肤和粘膜出现特征性靶形斑点的疾病。虽然大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 时，重点是使用含类固醇或抗组胺药的外用乳膏以缓解症状。为每位患者量身定制的复发性 EM 治疗方案最为有效。首选的治疗方式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针对受累粘膜的药物溶液。对于抗病毒药物无效的患者，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 通常在 2 至 4 周内自行消退。史蒂文斯-约翰逊综合征是一种严重的黏膜累及性疾病，病程可长达 6 周。对于轻度病例，一般不建议使用类固醇。对于严重的多形红斑是否应使用类固醇仍不确定，因为随机对照研究尚未明确哪些儿童能从此治疗中获益。
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.
我们报道一例因 TMP/SMX 引发的口腔 erythema multiforme (EM) 病例，表现为典型的口腔及唇部溃疡，未见皮肤损害。这提示需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 Prednisone(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、有时还涉及粘膜的反应，由免疫系统触发。通常表现为靶样病变，可能为孤立、复发或持续存在。这些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，后者常表现为广泛红斑或紫癜并伴有水疱。Erythema multiforme 的治疗包括局部类固醇或抗组胺药以缓解症状并处理根本原因。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。严重的粘膜受累可能需要住院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（亦可累及粘膜）不等。侵犯粘膜或出现大疱是评估严重程度的重要标志。
- Erythema multiforme minor：典型的靶形病变或分布于肢端的凸起、水肿性丘疹。轻度形式通常表现为轻度瘙痒（但有时瘙痒可非常剧烈）、粉红色斑点，对称排列，起始于四肢。该疾病的典型过程是皮疹在 7–10 天内自行消退。
- Erythema multiforme major：典型的靶形病变或凸起、水肿性丘疹，分布于肢端，累及单层或多层粘膜。表皮脱落涉及的体表面积不足 10%。
○ 治疗 – 非处方药
如果伴有发热（体温升高），建议尽快就医。可疑药物应立即停用（如抗生素、非甾体抗炎药）。口服抗组胺药，例如 cetirizine（西替利嗪）和 loratadine（氯雷他定），可用于止痒。
#Cetirizine [Zytec]
#LevoCetirizine [Xyzal]
#Loratadine [Claritin]