What is it?
Erythema multiforme is a hypersensitivity reaction usually triggered by infections, most commonly herpes simplex virus (HSV).
- It presents with a skin eruption characterised by a typical target lesion. There may be mucous membrane involvement.
- It is acute (appears with in 3 days of the cause) and self-limiting (normally heals within 7 days), usually resolving without complications.
- It can reoccur several times within a year.
- Erythema multiforme is divided into major and minor forms and is now regarded as distinct from Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN)
- Erythema multiforme most commonly affects young adults (20–40 years of age), however all age groups and races can be affected.
- There is a male predominance.
- There is a genetic tendency to erythema multiforme. Certain tissue types are more often found in people with herpes-associated erythema multiforme (HLA-DQw3) and recurrent erythema multiforme (HLA-B15, -B35, -A33, -DR53, -DQB1*0301).
Cause
What triggers erythema multiforme?
Infections
- Infections are probably associated with at least 90% of cases of erythema multiforme.
- The single most common trigger for developing erythema multiforme is herpes simplex virus (HSV) infection, usually herpes labialis (cold sore on the lip) and less often genital herpes.
- HSV type 1 is more commonly associated than type 2.
- The herpes infection usually precedes the skin eruption by 3–14 days.
- Mycoplasma pneumonia (a lung infection caused by the bacteria Mycoplasma pneumoniae) is the next most common trigger.
- Many different virus infections have been reported to trigger erythema multiforme including:
- Dermatophyte fungal infections (tinea) have also been reported in association with erythema multiforme.
Medication
- Medications are probably an uncommon cause (<10%) of erythema multiforme. If this diagnosis is being seriously considered then alternative drug eruptions should be excluded, such as:
- Many medications have been reported to trigger erythema multiforme i.e.
DermNet New Zealand
Complications /Information to beware of/General tips:
This condition may show similar symptoms to:
Please talk to your healthcare professional (i.e. Medical Doctor/Pharmacist) for further advice
Detailed Information
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