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Erythema Multiforme, Emergency Medicine

Gregory W. Hendey Reviewed 06/2017
 


Basics

Description

  • A rash caused by a hypersensitivity reaction:

    • May occur in response to various medications, infections, or other illness

  • Erythema multiforme (EM) minor:

    • Typical target lesions

    • Edematous ...

Diagnosis

Signs and Symptoms

History

  • Prodrome: Infrequent systemic symptoms (mild fever/malaise), antecedent HSV in most cases (within 3 wk)

  • Usually not associated with severe systemic illness

Physical Exam

Treatment

Pre-Hospital

Not contagious and does not require isolation or postexposure prophylaxis for exposed personnel 

Initial Stabilization/Therapy

Generally benign and self-limited, requiring no initi...

Follow-Up

Disposition

Admission Criteria

  • Admission is not needed unless required for another concurrent disorder.

  • Unable to take PO fluids secondary to mucosal lesions

Discharge Criteria

EM is generally a ...

Pearls and Pitfalls

  • In patients with severe systemic illness, a more serious diagnosis should be considered, such as SJS or TEN.

  • Most patients with EM have underlying HSV infection.

  • Secondary syphilis m...

Additional Reading

  • Dyall-Smith  D. Erythema multiforme. Available at www.dermnetnz.org. Accessed on July 1, 2011.

  • Lamoreux  MR, Sternbach  MR, Hsu  WT. Erythema multiforme. Am Fam Physician.  2006...

Codes

ICD9

  • 695.10 Erythema multiforme, unspecified

  • 695.13 Stevens-Johnson syndrome

  • 695.15 Toxic epidermal necrolysis

  • 695.19 Other erythema multiforme

  • 695.11 Erythema multiforme minor

  • 695.12 Erythema multifo...

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