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erythema multiforme

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Erythema multiforme

Erythema multiforme is a skin reaction that results in red target-shaped patches on the skin.

What is going on in the body?
This condition is an allergic skin reaction commonly caused by an infection or a medication. Severe reactions can involve the skin, lungs, kidneys, eyes and other areas. In rare, severe cases, death may occur.

What are the signs and symptoms of the condition?
Signs and symptoms of this condition include:
  • reddish purple target-shaped patches on the skin, especially the palms and soles
  • hive-like areas on the skin, which are raised swollen areas, that do not clear up like true hives
  • ulcers and tender areas of the surfaces of the mouth, eyes, and genitals
  • general discomfort
  • fatigue
  • fever
Severe cases may cause the skin to peel off and result in serious eye inflammation and other signs and symptoms.

What are the causes and risks of the condition?
This condition may be caused by:
  • medications, such as certain antibiotics
  • infections, such as with the herpes virus
  • cancer, such as leukaemia, a type of blood cancer
  • pregnancy
Often, the cause is unknown.

The primary risks of this condition are skin infections, scarring of the skin, vision problems, and even death.

What can be done to prevent the condition?
Prevention of this condition is only possible when the cause is known. If it were caused by a medication, the drug would need to be stopped. Medications used to treat herpes, such as acyclovir may prevent recurrence if the condition is due to a herpes outbreak. Most cases are not preventable.

How is the condition diagnosed?
This condition is usually diagnosed by its appearance. In some cases, a skin biopsy may be needed. This involves taking a small piece of skin with a special tool. This piece can then be analysed to make the diagnosis.

What are the long-term effects of the condition?
Scarring or infection of the skin, vision problems, scarring in the gut, and even death may result from severe forms of this condition. Most cases do not cause any long-term effects.

What are the risks to others?
There is no risk to others. This condition is not contagious.

What are the treatments for the condition?
Treatment of the condition may involve:
  • stopping the medication causing the problem
  • treating the infection causing the reaction
  • medications to help the skin heal
  • medications to reduce inflammation in the eye
  • treating complications, such as a skin infection
What are the side effects of the treatments?
All medications have possible side effects. These may include allergic reactions, stomach upset, and other side effects. Specific side effects depend on the drugs used.

What happens after treatment for the condition?
Most people recover without a problem and can return to normal activities. The condition can recur. If caused by herpes, a person may want to consider taking drugs to prevent further herpes outbreaks. If caused by drugs, the person should avoid the drug in the future.

How is the condition monitored?
In mild cases, the skin is monitored until the rash disappears, usually by the affected person at home. In serious cases, a person may need to be admitted to the hospital for closer monitoring. The doctor in this setting often does repeated examinations. Further monitoring depends on whether or not any complications develop.

Author: Lynn West, MD
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Potential conflict of interest information for reviewers available on request

This website and article is not a substitute for independent professional advice. Nothing contained in this website is intended to be used as medical advice and it is not intended to be used to diagnose, treat, cure or prevent any disease, nor should it be used for therapeutic purposes or as a substitute for your own health professional's advice.  All Health and any associated parties do not accept any liability for any injury, loss or damage incurred by use of or reliance on the information.


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