A reaction pattern of skin consisting of a variety of lesions but most commonly erythematous papules and bullae. “Target” or “iris” lesion is characteristic and consists of concentric circles of erythema and normal flesh-colored skin, often with a central vesicle or bulla.
Distribution of lesions classically acral, esp. palms and soles. Three most common causes are drug reaction (particularly penicillins and sulfonamides) or concurrent herpetic or Mycoplasma infection. Can rarely affect mucosal surfaces and internal organs (erythema multiforme major or Stevens-Johnson syndrome).
Treatment: Erythema Multiforme Provocative agent should be sought and eliminated if drug-related. In mild cases limited to skin, only symptomatic treatment is needed (antihistamines, NSAID). For Stevens-Johnson syndrome, systemic glucocorticoids have been used but are controversial; prevention of secondary infection and maintenance of nutrition and fluid/electrolyte balance are critical. |