5-Minute Clinical Consult: Erythema Multiforme

Erythema Multiforme

Description

An acute self-limited hypersensitivity reaction involving the skin and sometimes the mucus membranes:
- Erythema multiforme (also called the erythema multiforme Hebra) is a mild disease that appears as a pleomorphic rash and includes target lesions, but not large vesicles or petechia, affecting the skin with or without involving 1 mucus membrane site.
- Three clinical subgroups have been identified:
  - Classical: A single episode as described;
  - Recurrent: Episodes recur, usually in synchrony with herpes simplex outbreaks
  - Persistent: Rare; only 23 cases having been reported in the world literature
Acceptance of the diagnostic criteria for erythema multiforme is not universal. Much of the literature consists of reports of 1 or 2 cases with “an erythema multiform-like rash.” Many authors refer to episodes of Stevens-Johnson syndrome as erythema multiforme, or erythema multiforme major, and others describe patients with oral lesions but no rash as “atypical erythema multeforme.” Some authors consider erythema multeforme to be a mild form of Stevens-Johnson syndrome, but there appears to be a growing consensus that the 2 are unrelated (11).
System(s) affected: Skin/Exocrine
Synonym(s): Erythema exudativum multiforme

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