Erythema multiforme (EM) is an uncommon, self-limiting, immune-mediated, mucocutaneous disease.
Approximately 90% of cases are triggered by infectious agents (herpes simplex virus is most common...
Diagnosis is based on history and clinical findings, and most cases do not require further work-up.
In unclear cases, histopathologic analysis including immunofluorescence microscopy and othe...
Treatment will depend on disease severity, underlying cause, and course of the disease.
Determine the level of care: outpatient versus inpatient.
Determine the cause of EM ...
L51.0 Nonbullous erythema multiforme
L51.1 Stevens-Johnson syndrome
L51.3 Stevens-Johnson syndrome-toxic epidermal necrolysis overlap syndrome
L51.9 Erythema multiforme, unspecified
L51.2 Toxic...
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dermatitis herpetiformis
<bold>Figure 1-3</bold> Ill-appearing child with Stevens-Johnson syndrome. (Courtesy of Joseph Lopreiato, MD.)
Eruption occurring in a young man who received amoxicillin just prior to mononucleosis diagnosis
Close-up of previous patient
Erythema multiforme–like eruption on the patient's arm. Notice the dusky, target-like appearance. (Dermik Laboratories, Inc.)
From Sauer G. C., Hall J. C. [1996]. Manual of skin diseases [7th ed.]. Philadelphia: Lippincott-Raven.
From Sauer G....
Erythema multiforme. Target lesions (A), which consist of a red ring around a clear area (sometimes with a central bull's eye), characterize erythema multiforme. In severe cases (B, C) or with involvement of the mucous membranes (Stevens–Johnson syndrome), vesicles may appear.
From Fleisher GR, MD, Ludwig S, MD, Baskin MN, MD. Atlas of Pediatric Emergency Medicine. Philadelphia: Lippincott Williams & Wilkins, 2004.
Erythema multiforme. Target lesions (A), which consist of a red ring around a clear area (sometimes with a central bull's eye), characteriz...
Urticaria - child with 2 day of itching, evanescent eruption
FIGURE 7.18 Urticaria. Dermal vasodilatation occurs, with no epidermal change (scale).
1.70. One month after the acute onset of Stevens-Johnson syndrome, there is still active conjunctival and corneal inflammation and already significant symblepharon formation.
1.70. One month after the acute onset of Stevens-Johnson syndrome, there is still active conjunctival and corneal inflammation and already...
FIG. 2.13. Stevens-Johnson syndrome. A: Adolescent with Stevens-Johnson syndrome secondary to sulfonamides. Note the involvement of mucous membranes of the mouth. B: Same child. Note the distribution of lesions.
FIG. 2.13. Stevens-Johnson syndrome. A: Adolescent with Stevens-Johnson syndrome secondary to sulfonamides. Note the involvement of mucous...
FIG. 6.7. Erythema multiforme. Target lesions (A), which consist of a red ring around a clear area (sometimes with a central bull's eye), characterize erythema multiforme. In severe cases (B, C) or with involvement of the mucous membranes (Stevens-Johnson syndrome), vesicles may appear.
FIG. 6.7. Erythema multiforme. Target lesions (A), which consist of a red ring around a clear area (sometimes with a central bull's eye), ...
Erythema multiforme.
Courtesy of George A. Datto, III, MD
Erythema multiforme. Steroid-responsive target papules, characterized by central bullae with surrounding erythema, appeared after antibiotic therapy.
Elder AD, Elenitsas R, Johnson BL, et al: Synopsis and Atlas of Lever's Histopathology of the Skin. Lippincott Williams & Wilkins, Philadelphia, 1999, p 2, clin. fig. IA1; p 163, clin. fig. IVE3; p 167,
Erythema multiforme. Steroid-responsive target papules, characterized by central bullae with surrounding erythema, appeared after antibioti...
(A) Bulla, (B) Target (or iris) lesion (in erythema multiforme)
From Bickley, LS, Szilagyi, P. Bates' Guide to Physical Examination and History Taking, 8th Ed. Philadelphia: Lippincott Williams & Wilkins 2003
From Bickley, LS, Szilagyi, P. Bates' Guide to Physical Examination and Hi...
Erythema multiforme major (Stevens-Johnson Syndrome). Bullae and hemorrhagic crusts are noted on the lips of this patient. He has targetoid lesions elsewhere on his body. From Goodheart HP. Goodheart's Photoguide to Common Skin Disorders: Diagnosis and Management, 3rd Edition. Philadelphia: Lippincott Williams & Wilkins, 2009.
Erythema multiforme major (Stevens-Johnson Syndrome). Bullae and hemorrhagic crusts are noted on the lips of this patient. He has targetoid...
<bold><italic>Figure 14.41.</bold></bold> Erythema multiforme. <bold>A.</bold> Early. <bold>B.</bold> Late.
<bold><italic>Figure 14.41.</bold></bold> Erythema multiforme. <bold>A.</bold> Early. <bold>B....
<bold>Figure 72-8</bold> Hemorrhagic ulcerative stomatitis in SJS. (Courtesy of Joseph Lopreiato, MD.)
<bold>FIGURE 61-20</bold> Erythema-multiforme–like eruption on the patient's arm. Notice the dusky, target-like appearance. (Dermik Laboratories, Inc.) (Sauer G.C., Hall J.C. [1996]. <italic>Manual of skin diseases</bold> [7th ed.]. Philadelphia: Lippincott-Raven)
<bold>FIGURE 61-20</bold> Erythema-multiforme–like eruption on the patient's arm. Notice the dusky, target-like appearance. (De...