Erythema multiforme (EM) is the name applied to a group of hypersensitivity disorders, affecting mostly children and young adults, and characterized by symmetric red, patchy lesions, primarily on the arms and legs. The cause is unknown, but EM frequently occurs in association with herpes simplex virus, suggesting an immunologic process initiated by the virus. In half of the cases, the triggering agents appear to be medications, including anticonvulsants, sulfonamides, nonsteroidal anti-inflammatory drugs, and other antibiotics. In addition, some cases appear to be associated with infectious organisms such as Mycoplasma pneumoniae and many viral agents. Erythema multiforme is the mildest of three skin disorders that are often discussed in relation to each other. It is generally the mildest of the three. More severe is Stevens-Johnson syndrome.
Erythema iris (herpes iris), formerly regarded as a separate disease, simply represents a manifestation of concentric, erythematous rings upon which vesicles or blebs may occur. This is an abstract of a report from the National Organization for Rare Disorders (NORD). A copy of the complete report can be downloaded free from the NORD website for registered users. The complete report contains additional information including symptoms, causes, affected population, related disorders, standard and investigational therapies (if available), and references from medical literature. erythema multifor´me a symptom complex representing a reaction of the skin and mucous membranes secondary to various known, suspected, and unknown factors, including infections, ingestants, physical agents, malignancy, and pregnancy. The risk factors and mechanisms that determine the onset of these reactions have been topics of great interest because of their connection to the physical deformities that result from nerve damage (Illarramendi et al. Extensive skin involvement may cause the loss of large quantities of body fluids, causing shock in addition to the risk of infection.
NORD recommends that affected individuals seek the advice or counsel of their own personal physicians. This disease entry is based upon medical information available through the date at the end of the topic. Since NORD’s resources are limited, it is not possible to keep every entry in the Rare Disease Database completely current and accurate. Please check with the agencies listed in the Resources section for the most current information about this disorder. Anemia, chlorosis, rheumatism, gout and other nutritive disturbances, malaria and other endemic diseases, have all been cited as predisposing causes, and it is questionable if the relationship is any closer. Exciting causes may be exposure, local irritants of any sort, internal or external infections, ingestion of such drugs as quinin, chloral, antipyrin, copaiba, arsenic, the iodids and bromids. Certain articles of diet may cause attacks in individuals susceptibly inclined, and I have seen no less than eleven cases occurring in immigrants just landed, where no doubt change of surroundings, lack of exercise and unusual food on shipboard have been the underlying factors.
Ossler has contributed much valuable data on the relation of the erythema group and visceral conditions, claiming that the skin lesions are merely surface reflections of visceral disorders. If there is any one factor which seems etiological in the majority of cases, it is ptomaine, either introduced in certain foodstuffs or developed in the digestive tract. This affection is regarded by most observers as an angioneurosis. The poisons, no matter what their nature or origin, act upon the nerve centre and cause the dermal manifestations. A microscopic examination of the skin shows nothing characteristic. Diagnosis. If you or your loved one reapplies or appeals the denial, consider this.
Papular eczema presents smaller papules which persist longer and itch more than those of erythema. They do not enlarge and may become vesicular, and the early systemic symptoms of erythema are not present. Measles and rotheln should be readily differentiated but the bullous erythema may simulate pemphigus or dermatitis herpetiformis. Prognosis and Treatment. Any form is liable to recur. The duration of an ordinary attack is between ten days and five weeks. In severe cases pigmentation may be persistent, and in complicated cases the prognosis must depend upon the nature of the associated disease.
Being a self-limited disease, it would seem that the treatment should be largely causal in nature. Hence saline enemas, intestinal antiseptics, laxatives or cultures of the bacillus Bulgaricus in some form may be necessary when intestinal autoinfection is suspected, or if the causes are external and local they need only to be removed. What can a healthy sex life do for you? The pathogenetic treatment is all-important, and the following remedies are suggested: Aconite, Agar., Apis, Antipy, Bell., Chin. sul., Chloral., Cicuta, N. mur., N.phos., Rhus tox., Sal. acid, Sulph.
acid, Urt. urens. Vespa.