Erythema multiforme, also known as Stevens-Johnson syndrome and toxic epidermal necrosis, is a rare and serious skin disorder that is found in people of all ages, including toddlers. Skin lesions, fever and itching are just a few characteristics of this difficult disease. According to the American Academy of Family Physicians (AAFP), mild, moderate and lethal forms of erythema multiforme exist.
Symptoms
According to Medline Plus, symptoms of erythema multiforme include fever, itching, joint pain and many symmetrical skin lesions . These skin lesions can appear as nodules (raised bumps), papules (raised spots) or macules (flat colored areas) with a target or bulls-eye appearance. They are found most commonly on the arms, legs, hands, feet and upper body.
Causes
According to Medline Plus, the exact cause of erythema multiforme is unknown. However, erythema multiforme in children is most commonly associated with a fungus called Mycoplama pneumoniae. In adults, erythema multiforme is associated with a virus called Herpes simplex, according to AAFP. More severe forms of erythema multiforme are the result of such medications as penicillins and non-steroidal anti-inflammatory drugs (NSAIDS).
Diagnosis
According to Medline Plus, diagnosis is based on the skin lesion's physical appearance. Specific tests performed include the Nikolsky's sign (skin forms blister when rubbed) and a skin lesion biopsy (sample) that is examined under the microscope.
Treatment
According to AAFP, the first step in treating erythema multiforme is investigating its cause. Mild cases of erythema multiforme do not require treatment but topical steroids and antihistamines can relieve symptoms. Patients with more severe forms of erythema multiforme can be treated with antibiotics, corticosteroids and intravenous immunoglobulins (antibodies that help with infection), according to Medline Plus.
Prognosis
According to Medline Plus, mild forms of erythema multiforme usually improve within two to six weeks. More severe forms, like Stevens-Johnson syndrome and toxic epidermal necrosis are difficult to treat and therefore lethal.
