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。
References
Erythema multiforme (EM) 是一种由于免疫反应而在皮肤和粘膜上出现独特的靶状斑点的情况。尽管通常由病毒感染（尤其是单纯疱疹病毒 (HSV) ）或某些药物引发，但在许多情况下其原因仍不清楚。治疗急性 EM 的重点是使用含有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治疗复发性 EM 的方法最为有效。最初的方法包括口服和局部治疗。这些包括皮质类固醇和抗病毒药物。局部治疗包括强效类固醇乳膏和针对受影响粘膜的溶液。对于抗病毒药物无反应的患者，二线选择包括免疫抑制药物、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
在许多情况下，轻度 erythema multiforme 会在 2 至 4 周内自行消失。史蒂文斯-约翰逊综合征是一种影响粘膜的严重疾病，可持续长达 6 周。对于轻度病例，通常不建议使用类固醇。类固醇是否应该用于治疗严重的多形红斑尚不确定，因为随机研究没有明确的结果表明哪些儿童会从这种治疗中受益。
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.
我们介绍一例由 TMP/SMX 引起的口腔 erythema multiforme (EM) 病例，表现为典型的口腔和唇部溃疡，无皮损。这强调了将其与其他口腔溃疡性疾病区分开来的必要性。患者接受对症治疗和泼尼松龙片治疗，停止 TMP/SMX 治疗后病情好转。
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，它表现为靶样病变，可能是孤立的、复发的或持续存在的。这些病变通常对称地影响四肢，特别是其外表面。主要原因包括单纯疱疹病毒和肺炎支原体等感染，以及某些药物、免疫接种和自身免疫性疾病。 erythema multiforme 与荨麻疹的区别取决于病变的持续时间； erythema multiforme 病变至少保持固定 7 天，而荨麻疹病变通常在一天内消失。尽管相似，但将 erythema multiforme 与更严重的史蒂文斯-约翰逊综合征区分开来至关重要，后者通常表现为广泛的红斑或紫癜，伴有水疱。 erythema multiforme 的治疗包括使用局部类固醇或抗组胺药缓解症状并解决根本原因。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.
病情从轻微的自限性皮疹到严重的危及生命的多形性红斑（也累及粘膜）不等。侵犯粘膜或出现大疱是严重程度的重要标志。
- Erythema multiforme minor：典型的目标或分布在肢端的凸起、水肿性丘疹
轻度形式通常表现为轻度瘙痒（但瘙痒可能非常严重）、粉红色斑点，对称排列，从四肢开始。这种疾病的正常情况是皮疹在 7-10 天内消退。
- Erythema multiforme major：典型的目标或凸起、水肿性丘疹，分布于肢端，累及一层或多层粘膜。表皮脱离涉及不到身体表面积的10%。
○ 治疗 - 非处方药
如果伴有发烧（体温升高），建议尽快去医院就诊。
可疑药物应停用。 （例如抗生素、非甾体抗炎药）
口服抗组胺药，例如西替利嗪和氯雷他定止痒。
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