Erythema Multiforme

(Erythema Multiforme Minor; Erythema Multiforme Major)

Definition

Erythema multiforme is a skin condition often associated with an overreaction to an infection (usually herpes simplex) or medication. It can affect skin throughout the body. Erythema multiforme has 2 forms:
  • Erythema multiforme minor—most common, is generally mild and may go away on its own, and usually caused by a virus
  • Erythema multiforme major—rare, usually more severe, less likely go away on its own, and usually caused by medications

Causes

Erythema multiforme is an overreaction of the immune system to a certain trigger. Some erythema multiforme is associated with an infection or certain medications, though the exact trigger may not be known half the time. It is not clear why some people have this reaction.

Risk Factors

Erythema multiforme is more common in young adults.Factors that may increase your chance of getting erythema multiforme include:
  • History of erythema multiforme
  • Infection or history of infection caused by:
    • Virus—herpes infection is the main cause in erythema multiforme minor
    • Bacteria
    • Fungus
    • Parasite
  • Certain medications (usual cause of erythema multiforme major), such as:
    • Antibacterials
    • Anticonvulsants
    • Non-steroidal anti-inflammatory drugs
  • Certain vaccinations including:
    • Diptheria and tetanus vaccine
    • Hepatitis B vaccine
    • Smallpox vaccine
Red Blistered Skin
Skin blister boil
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Symptoms

Symptoms can vary from mild to severe. Both erythema multiforme minor and major cause skin lesions that:
  • Are itchy or burning
  • Typically develop over 3-4 days, but at different times. Lesions will look different in various places of the body.
  • Often start on hands and feet and spread to legs, arm, and face
  • Start out as small, red areas, and grow to circular, raised areas. The middle is often a dark red which fades to a pale pink and is surrounded by a bright red edge. The different colors make the lesions look like mini targets.
  • May have a blister or crust in the center
  • Appears equally on both sides of the body
  • May develop in one mucus membrane such as the lips, inside the mouth, or the eyes
Erythema multiforme major may also cause:
  • General ill feeling, fever, and achy joints before the rash appears
  • More extensive rash
  • Lesions that develop in 2 or more mucus membranes such as the lips, inside the mouth, or the eyes

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