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Erythema Multiforme

Losika Sivaganeshan, MD and Pradeepa Vimalachandran, MD Reviewed 06/2018
 


BASICS

  • Erythema multiforme (EM) is relatively common, acute, recurrent, self-limiting inflammatory disease.

    • Mostly (~90% of cases) triggered by infectious agents (up to 50% by herpes simplex virus [H...

DIAGNOSIS

Clinical 

HISTORY

  • Absent or mild prodromal symptoms

  • Acute, self-limiting, episodic course

  • History of new medication

  • Preceding HSV infection 10 to 15 days before the skin eruptions

  • Rash involving t...

TREATMENT

GENERAL MEASURES

  • Step 1: Discontinue or treat inciting factor (1).

  • Wound care for severe cases with epidermal detachment

  • Oral lesions should be addressed to insure maintenance of PO intake. Thi...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

Patient Monitoring

  • The disease is self-limiting.

  • Complications are rare, with no mortality.

DIET

As tolerated, with increased fluid intake 

PATIENT EDUCATION

  • The diseas...

REFERENCES

1 Sokumbi O, Wetter DA. Clinical features, diagnosis, and treatment of erythema multiforme: a review for the practicing dermatologist. Int J Dermatol.  2012;51(8):889–902.  [View Abs...

ADDITIONAL READING

  • Sola CA, Beute TC. Erythema multiforme. J Spec Oper Med.  2014;14(3):90–92.  [View Abstract]

  • Wetter DA, Davis MD. Recurrent erythema multiforme: clinical characteristics, etiol...

SEE ALSO

Cutaneous Drug Reactions; Dermatitis Herpetiformis; Pemphigoid Gestationis; Stevens-Johnson Syndrome; Toxic Epidermal Necrolysis; Urticaria 

CODES

ICD10

  • L51.9 Erythema multiforme, unspecified

  • L51.8 Other erythema multiforme

  • L51.0 Nonbullous erythema multiforme

ICD9

  • 695.10 Erythema multiforme, unspecified

  • 695.11 Erythema multiforme minor

  • 695.12 Er...

CLINICAL PEARLS

  • EM is diagnosed clinically by careful review of the history, thorough detailed physical exam, and by excluding other similar disorders. No lab tests are required for the diagnosis.

  • Typi...

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