Dr. M.J. Bazos, MD
Patient Handout
ERYTHEMA
MULTIFORME
About Your
Diagnosis
Erythema Multiforme is a relatively common
disorder that affects the skin and sometimes the internal organs. The extent of
involvement of the internal organs varies greatly, but widespread or severe
involvement is rare. There are many causes of erythema multiforme. These include
viral and bacterial infections, certain chronic diseases, pregnancy, cancer, and
others. In more than half of all cases a cause cannot be found. The diagnosis
can usually be made on examination by a doctor, but a biopsy is frequently done
to confirm the diagnosis. Most cases of erythema multiforme resolve with
treatment, but severe cases may require
hospitalization.
Living With Your
Diagnosis
In the minor form of erythema
multiforme, there are round, red bumps and blisters on both sides of the body
that occur on the arms, legs, face, and lips. These bumps can take on the
appearance of red or pink targets, or they can become large blisters. The rash
itches a lot and may develop into hives. It usually affects children and young
adults and lasts from 2 to 4 weeks. Fever and muscle and joint aches may be
present. It can recur during the first few years. Erythema multiforme major,
also called Stevens- Johnson syndrome, is a more serious illness with high
fever, large blisters, and ulcers on membranes of the mouth, nose, eyes, genital
area, arms, and skin. There may be severe itching and occasionally lung
involvement. If there are no complications, symptoms resolve in 4 weeks, but
mouth sores can persist for months. Untreated eye involvement can lead to
blindness. Severe cases require hospitalization.
Treatment
Mild
cases of erythema multiforme may not require any treatment. Prednisone may be
used if necessary. If your doctor suspects a medication you are taking may have
caused your problem, the medication will be stopped. Antibiotics are used when a
secondary infection occurs. Any medical illness causing erythema multiforme
should be treated as appropriate. Steroid creams applied to skin may be
prescribed. Erythema multiforme associated with herpes simplex virus can recur,
and preventive medications are frequently used. Itching can be controlled with
antihistamines such as Benadryl. Mouth pain is frequently treated with lidocaine
rinses. Eye involvement may require a consult with an eye
specialist.
The
DOs
• Apply cool wet
Burow’s compresses to blisters, or just a cool wet cloth can be
used.
• Call your doctor immediately
if any vision changes occur.
• Take
acetaminophen for pain unless otherwise directed by your
doctor.
The
DON’Ts
• Don’t apply
skin creams or ointments to broken or bleeding
skin.
• Don’t take hot baths or
hot showers. These can make the skin itch more. Cool or lukewarm baths may
help.
• Avoid strenuous or vigorous
activities if ill with fever, headaches, or
malaise.
When to Call Your
Doctor
• Call immediately if any
decreased vision or eye pain develops during
treatment.
• If persistent vomiting
or diarrhea occur.
• If new symptoms
occur during treatment, or if symptoms worsen
significantly.