Erythema multiforme is a common skin disorder. It consists of target-like circular lesions. They have a red center, pale ring, and dark red outer ring. These lesions appear suddenly on the legs, arms, palms, hands, feet, and inside the mouth.
Erythema multiforme minor is the most frequent form. It is generally mild.Erythema multiforme major, while rare, can be life-threatening. This severe form of the disorder usually causes target lesions with painful blisters at their center. They tend to appear on the trunk, eyes, inside the mouth, and genitals. It is also called Stevens-Johnson syndrome.In some cases this condition can be caused by a reaction to an infection or certain medications. Often the cause is unknown.
Erythema multiforme minor is most commonly associated with:
Herpes simplex virus—the same virus that causes cold sores
Other triggers connected with erythema multiforme major include:
Mycoplasma infection (bacterial lung infection)Cocaine useHistory of radiotherapy
Certain medications, such as:
SulfonamidesTetracyclinesAmoxicillinAmpicillinNonsteroidal anti-inflammatory drugsAnticonvulsants
Exposure to any of the known causes increase the risk. The conditions more commonly occurs in:
Individuals who have had it beforeIndividuals with history of cold sores (orolabial herpes) or genital herpesChildren and young adultsMales more than females
Individuals who are
HIV
positive
Symptoms can vary from mild to severe. If you have any of these do not assume it is due to erythema multiforme. These symptoms may be caused by other health conditions. If you experience any one of them, see your doctor.
Skin lesions or spots
Typically appear over 3-4 daysStart on hands and feet and spread to legs, arm, and faceSpots start out as small, red areas, and progress to look like mini targetsSpots may blisterRash appears equally on both sides of the bodyRash resolves in 1-6 weeks
Other possible symptoms include:
ItchingFeverOverall ill feelingAchy jointsVision problemsBloodshot or dry eyesBurning, painful, or itchy eyesMouth soresYour doctor will ask you about your symptoms and medical history. You may be referred to a doctor who specializes in skin problems.
Most cases can be diagnosed based on your medical history and skin exam. If target lesions are present, then diagnosis is clear. The skin lesions may not be typical. In this case, a biopsy of the skin may be done. The skin sample is examined under a microscope.
Treatment for this condition involves:
Eliminating the trigger or cause (if known)Relieving the symptomsPreventing infection of the lesions (in erythema multiforme major)Treatment options include the following:
Moist compressesOral antihistamines to help control itchingTopical steroid creams to help discomfort and itchingAcetaminophen
to reduce pain and fever
Potassium iodide
Given if the outbreak is caused by herpes simplexPrevent recurrenceNot effective in treating the current rashMost often used for people with frequent outbreaks
Oral or IV steroids—for severe cases may be treated with (there is some controversy about the effectiveness of this option)Hospitalization—for widespread, life-threatening lesionsIf you develop this condition, it will be important to find what triggered it. Avoid the trigger to help prevent its recurrence.
If herpes simplex virus is the trigger, your doctor may prescribe a daily oral antiviral medication. This will help to prevent this condition.