21. ► Erythema Multiforme A medical encycopedia article on the topic erythema multiforme. http://www.umm.edu/ency/article/000851.htm

var MenuLinkedBy='AllWebMenus [2]', awmBN='530'; awmAltUrl=''; Disease Nutrition Surgery Symptoms Injury ... Encyclopedia (English) Toggle English Spanish Erythema multiforme Overview Symptoms Treatment Prevention Definition: Erythema multiforme is a skin disorder resulting from an allergic reaction Alternative Names: Lyell's syndrome; Stevens-Johnson syndrome; Toxic epidermal necrolysis Causes, incidence, and risk factors: Erythema multiforme is a type of hypersensitivity (allergic) reaction that occurs in response to medications, infections, or illness. Medications associated with erythema multiforme include sulfonamides, penicillins, barbiturates, and phenytoin. Associated infections include herpes simplex and mycoplasma infections. The exact cause is unknown. The disorder is believed to involve damage to the blood vessels of the skin with subsequent damage to skin tissues. Approximately 90% of erythema multiforme cases are associated with herpes simplex or Mycoplasma infections. The disorder occurs primarily in children and young adults. Erythema multiforme may present with a classic skin lesion with or without systemic (whole body) symptoms. In Stevens-Johnson syndrome, the systemic symptoms are severe and the lesions are extensive, involving multiple body areas (especially the mucous membranes). Toxic epidermal necrolysis (TEN syndrome, or Lyell's syndrome) involves multiple large

22. Erythema Multiforme - Dermatology Health Guide Overview of erythema multiforme. erythema multiforme is a skin disorder characterized by symmetrically placed, red, raised skin areas all over the body. http://www.umm.edu/dermatology-info/emulit.htm

var MenuLinkedBy='AllWebMenus [2]', awmBN='530'; awmAltUrl=''; Dermatology Health Guide Anatomy of the Skin Common Skin Disorders... Describing a Skin Condition ... Glossary Related Resources Within UMM Dept. of Dermatology Translate using Google to Spanish German French Italian Portuguese Dermatology Erythema Multiforme What is erythema multiforme? Erythema multiforme is a skin disorder characterized by symmetrically placed, red, raised skin areas all over the body. These patches often look like "targets" (dark circles with purple-grey centers). The skin condition may be chronic and usually lasts for two to four weeks each time. Most often, this disorder is caused by the herpes simplex virus. Other causes may include: an interaction with a certain medication other infectious diseases certain vaccines What are the symptoms of erythema multiforme? The following are the most common symptoms of erythema multiforme. However, each individual may experience symptoms differently: sudden, red patches and blisters, usually on the palms of hands, soles of feet, and face flat, round red "targets" (dark circles with purple-grey centers)

23. Introduction: Erythema Multiforme - WrongDiagnosis.com Introduction to erythema multiforme as a medical condition including symptoms, diagnosis, misdiagnosis, treatment, prevention, and prognosis. http://www.wrongdiagnosis.com/e/erythema_multiforme/intro.htm

Home Symptoms Diseases Risks ... Diseases Search our medical database Subscribe to our free Newsletter sample Send this page to a friend Condition Lists By Organ By Symptom By Class By Prevalence ... List A-Z Current chapter: Erythema multiforme Next sections Basic Summary for Erythema multiforme Types of Erythema multiforme Causes of Erythema multiforme Risk Factors for Erythema multiforme ... Symptoms of Erythema multiforme Next chapters: Erythrasma Slap-cheek syndrome Erythroderma Erythromelalgia ... Feedback Introduction: Erythema multiforme Researching symptoms of Erythema multiforme: Further information about the symptoms of Erythema multiforme is available including a list of symptoms of Erythema multiforme , or alternatively return to research other symptoms in the symptom center Treatments for Erythema multiforme: Various information is available about treatments available for Erythema multiforme , or research treatments for other diseases. Causes of Erythema multiforme: Research more detailed information about the causes of Erythema multiforme , other possibly hidden causes of Erythema multiforme , or other general information about Erythema multiforme Statistics and Erythema multiforme: Various sources and calculations are available in statistics about Erythema multiforme , and you can also research other medical statistics in our statistics center Contents for Erythema multiforme: Basic Summary for Erythema multiforme Types of Erythema multiforme Causes of Erythema multiforme Risk Factors for Erythema multiforme ... Glossary for Erythema multiforme Last revision:

24. Basic Summary For Erythema Multiforme - WrongDiagnosis.com Overview of erythema multiforme as a medical condition including introduction, prevalence, prognosis, profile, symptoms, diagnosis, misdiagnosis, http://www.wrongdiagnosis.com/e/erythema_multiforme/basics.htm

Home Symptoms Diseases Risks ... Erythema multiforme Search our medical database Subscribe to our free Newsletter sample Send this page to a friend Condition Lists By Organ By Symptom By Class By Prevalence ... List A-Z Current chapter: Erythema multiforme Next sections Types of Erythema multiforme Causes of Erythema multiforme Risk Factors for Erythema multiforme Symptoms of Erythema multiforme ... Diagnostic Tests for Erythema multiforme Next chapters: Erythrasma Slap-cheek syndrome Erythroderma Erythromelalgia ... Feedback Basic Summary for Erythema multiforme Main name of condition: Erythema multiforme What is Erythema multiforme? Parent types of Erythema multiforme: Erythema Organs Affected by Erythema multiforme: skin Types of Erythema multiforme: Erythema multiforme major What causes Erythema multiforme? Causes of Erythema multiforme: see causes of Erythema multiforme Risk factors for Erythema multiforme: see risk factors for Erythema multiforme What are the symptoms of Erythema multiforme? Symptoms of Erythema multiforme: see symptoms of Erythema multiforme How is it treated? Treatments for Erythema multiforme: see treatments for Erythema multiforme Society issues for Erythema multiforme Hospitalization statistics for Erythema multiforme: The following are statistics from various sources about hospitalizations and Erythema multiforme: 0.009% (1,210) of hospital consultant episodes were for erythema multiforme in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)

25. Erythema Multiforme Detailed information on erythema multiforme, including symptoms and treatment. http://www.healthsystem.virginia.edu/uvahealth/adult_derm/emulit.cfm

[ Skip Navigation ] Health System Home For Health Answers Healthcare Professionals ... Advanced Search Health System Search Search for Information People UVa Home Health System News Health System Events (all) Health System Publications ... Making a Gift Topics All About Cancer Blood Disorders Bone Disorders Breast Health Cancer Cardiovascular Disease Dermatology Diabetes Digestive Disorders Endocrinology Environmental Medicine Eye Care Glossary Gynecological Health Infectious Diseases Kidney Disease Men's Health Mental Health Nervous System Disorders Non-Trauma Emergency Oral Health Orthopaedics Otolaryngology Pathology Pediatrics, General Health Prostate Health Radiology Respiratory Disorders Skin Cancer Surgical Care Urology Women's Health UVa Health Topics A to Z FIND A DOCTOR Allergy and Asthma General Dermatology Laser Surgery ... WHY CHOOSE UVA Search This Site Erythema Multiforme What is erythema multiforme? Erythema multiforme is a skin disorder characterized by symmetrical, red, raised skin areas all over the body. These patches often look like "targets" (dark circles with purple-grey centers). The skin condition may be chronic and usually lasts for two to four weeks each time. Most often, this disorder is caused by the herpes simplex virus. Other causes may include the following:

26. Erythema Multiforme - 1 Dept. of Dermatology University of Iowa College of Medicine. erythema multiforme - Left Foot - Annular Target Lesions. Return to Image Index page. http://tray.dermatology.uiowa.edu/EMult001.htm

Dept. of Dermatology - University of Iowa College of Medicine Erythema Multiforme - Left Foot - Annular Target Lesions Return to Image Index page. Return to Image Index page. Return to Dermatology's Home page. September, 1995

27. Erythema Multiforme - 2 Dept. of Dermatology University of Iowa College of Medicine. erythema multiforme - Right Foot - Annular Target Lesions. Return to Image Index page. http://tray.dermatology.uiowa.edu/EMult002.htm

Dept. of Dermatology - University of Iowa College of Medicine Erythema Multiforme - Right Foot - Annular Target Lesions Return to Image Index page. Return to Image Index page. Return to Dermatology's Home page. September, 1995

28. THE MERCK MANUAL, Sec. 10, Ch. 118, Inflammatory Reactions No cause of erythema multiforme can be found in 50% of cases. Almost any drug can cause erythema multiforme; penicillin, sulfonamides, http://www.merck.com/mrkshared/mmanual/section10/chapter118/118d.jsp

29. THE MERCK MANUAL--SECOND HOME EDITION, Erythema Multiforme In Ch. 203, Itching A erythema multiforme is a recurring disorder characterized by patches of red, Usually, erythema multiforme appears suddenly, with reddened patches http://www.merck.com/mmhe/sec18/ch203/ch203f.html

var externalLinkWarning = "The link you have selected will take you to a site outside Merck and The Merck Manuals.*n*nThe Merck Manuals do not review or control the content of any non-Merck site. The Merck Manuals do not endorse and are not responsible for the accuracy, content, practices, or standards of any non-Merck sources."; Search The Second Home Edition , Online Version Search Index A B C D ... Z Sections Accidents and Injuries Blood Disorders Bone, Joint, and Muscle Disorders Brain, Spinal Cord, and Nerve Disorders ... Women's Health Issues Resources Anatomical Drawings Multimedia Pronunciations Weights and Measures ... , Online Version Section Skin Disorders Chapter Itching and Noninfectious Rashes Topics Introduction Dermatitis Drug Rashes Erythema Multiforme Erythema Nodosum Granuloma Annulare Itching Keratosis Pilaris ... Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis Erythema Multiforme Buy The Book Print This Topic Email This Topic Pronunciations acyclovir corticosteroid dermatitis granuloma ... toxic epidermal necrolysis Erythema multiforme is a recurring disorder characterized by patches of red, raised skin that often look like targets and usually are distributed symmetrically over the body. Most cases are caused by a reaction to infection with the herpes simplex virus (see Viral Infections: Herpes Simplex Virus Infections ). This viral infection is apparent as visible cold sores in about two thirds of people before the erythema multiforme appears. Doctors are not sure if other infectious diseases also cause erythema multiforme. Doctors are unsure exactly how herpes simplex causes this disorder, but a type of immune reaction is suspected.

30. Mediscan: Search Results Your search erythema multiforme produced 39 results Results 1 to 24, Next . Page 1 of 2 1 2. View image information. 026873 erythema multiforme http://www.mediscan.co.uk/cfm/resultssearch.cfm?box=erythema multiforme&mediatyp

31. Health Information | Health & Safety Resources | Child Health & Safety | Childre erythema multiforme is an uncommon, selflimited symmetrical skin rash with target Occasionally, erythema multiforme is caused by a herpes simplex virus http://www.pediatricweb.com/seattle/article.asp?ArticleID=802&ArticleType=9

32. Postgraduate Medicine: Taking Aim At Erythema Multiforme To review the typical clinical findings of erythema multiforme Preview The first attack of erythema multiforme can be alarming to the victim, http://www.postgradmed.com/issues/2000/01_00/katta.htm

Taking aim at erythema multiforme How to spot target lesions and less typical presentations Rajani Katta, MD VOL 107 / NO 1 / JANUARY 2000 / POSTGRADUATE MEDICINE CME learning objectives To review the typical clinical findings of erythema multiforme To examine the evidence supporting herpes simplex virus infection as an inciting factor in erythema multiforme To learn treatment methods for erythema multiforme Preview : The first attack of erythema multiforme can be alarming to the victim, who is often an otherwise-healthy young adult. In a typical episode, a symmetric pattern of round, red lesions suddenly appears, frequently on the extremities, and erosions develop in the mouth. Fortunately, the condition is self-limited. Unfortunately, it is usually recurrent, possibly because of the ongoing, subclinical presence of herpes simplex virus. In this article, Dr Katta summarizes the latest information on erythema multiforme and its management. Katta R. Taking aim at erythema multiforme: how to spot target lesions and less typical presentations. Postgrad Med 2000;107(1):87-90 T he incidence of erythema multiforme is unknown, but the condition is relatively common. It occurs worldwide, in both men and women, and in people of any age (although most patients are under 40) (1).

33. Postgraduate Medicine: Pearls In Dermatology Recurrent HSVassociated erythema multiforme was diagnosed, Oral erythema multiforme lesions, with erosions and crusting of lesions on patient s lips. http://www.postgradmed.com/issues/1999/10_15_99/singla.htm

PEARLS IN DERMATOLOGY Erythema multiforme due to herpes simplex virus Recurring target lesions are the clue to diagnosis Rajanish Singla, MD; Robert T. Brodell, MD VOL 106 / NO 5 / OCTOBER 15, 1999 / POSTGRADUATE MEDICINE A 75-year-old man presented with a 5-day history of open sores in his mouth and on his lips, tongue, scrotum, and penis. In addition, he had an erythematous, edematous, slightly tender patch on his right palm measuring 2 cm in diameter. Biopsy of a crusted lesion on the scrotum revealed an erosion with underlying mixed inflammation including lymphocytes, neutrophils, and scattered eosinophils. A short course of prednisone and acyclovir was prescribed, and over the next 2 weeks, the lesions cleared. Two months later, the patient presented again with a 4-day history of blisters on his lips, tongue, and buccal mucosa. During that period, five or six erythematous, pruritic patches on his back and upper extremities had also appeared, and the blisters on his lips had crusted over (figure 1). Culture of a lesion on his lips was positive for herpes simplex virus (HSV). Biopsy of an erythematous patch on his back showed epidermal dyskeratosis, necrosis, and underlying lichenoid inflammation typical of erythema multiforme. The patient began a long-term course of suppressive acyclovir (200 mg twice daily), which was eventually discontinued after he was symptom-free for 8 months. Three months after therapy was discontinued, similar lesions returned. Oral lesions appeared first, then tender, erythematous target patches developed on the patient's back, arms, legs, and soles (figure 2). Recurrent HSV-associated erythema multiforme was diagnosed, and acyclovir in suppressive doses was again prescribed.

34. Bextra Erythema Multiforme erythema multiforme is a type of hypersensitivity reaction that occurs in response to medications, infections, or illness. http://www.vioxx.us.com/recall/Bextra-Erythema-Multiforme.html

Bextra Erythema Multiforme BREAKING NEWS: 11-10-04 - BEXTRA MORE THAN DOUBLES RISK OF HEART ATTACK - This week, researchers said a preliminary study indicated that Bextra, a painkiller in the same class as Vioxx, more than doubled the risk of heart attack. Bextra has also been linked to strokes, heart disease, Stevens-Johnson syndrome, toxic epidermal necrolysis, exfoliative dermatitis and erythema multiforme. Click Here for more information regarding Bextra. Erythema multiforme is a skin disorder resulting from an allergic reaction. Erythema multiforme is a type of hypersensitivity (allergic) reaction that occurs in response to medications, infections, or illness. Medications associated with erythema multiforme include sulfonamides, penicillins, barbiturates, and phenytoin. Associated infections include herpes simplex and mycoplasma infections. The exact cause has been attributed to0 the use of Bextra. The disorder is believed to involve damage to the blood vessels of the skin with subsequent damage to skin tissues. Approximately 90% of erythema multiforme cases are associated with herpes simplex or Mycoplasma infections. The disorder occurs primarily in children and young adults. Erythema multiforme may present with a classic skin lesion with or without systemic (whole body) symptoms. In Stevens-Johnson syndrome, the systemic symptoms are severe and the lesions are extensive, involving multiple body areas (especially the mucous membranes). Toxic epidermal necrolysis (TEN syndrome, or Lyell's syndrome) involves multiple large blisters (bullae) that coalesce, followed by sloughing of all or most of the skin and mucous membranes.

35. Erythema Multiforme DESCRIPTION erythema multiforme (EM) is an acute self limited hypersensitivity erythema multiforme minor also called the erythema multiforme - Hebra, http://www.5mcc.com/Assets/SUMMARY/TP0320.html

Erythema multiforme DESCRIPTION: Erythema multiforme (EM) is an acute self limited hypersensitivity reaction involving the skin and sometimes the mucus membranes. Erythema multiforme minor- also called the erythema multiforme - Hebra, is a mild form appearing as a pleomorphic rash which includes target lesions, but not large vesicles or petechia, affecting the skin with or without involving one mucus membrane site. Erythema multiforme major is a more severe form, involving more than one mucus membrane site. It was formerly considered to be the same as Stevens-Johnson syndrome, but is now believed to be unrelated. System(s) affected: Skin/exocrine Genetics: Possibly associated with HLA-B15 Incidence/Prevalence in USA: Not known. In Germany the incidence of erythema multiforme major, Stevens Johnson syndrome and toxic epidermal necrolysis combined appears to be 1.89 per million persons per year. Predominant age: Peak incidence in 20's and 30's; rare under 3 and over age 50 Predominant sex: CAUSES: Most cases appear to be due to a preceding infection. Drugs seem to be an infrequent cause.

36. Erythema Multiforme (1) erythema multiforme (1). Loyola University Medical Center. nonframe version Jason R. Swanson and Jeffrey L. Melton, MD. Last Updated 1996-12-30 203808 http://www.meddean.luc.edu/lumen/MedEd/medicine/dermatology/melton/erthmul1.htm

Erythema multiforme (1) non-frame version Jason R. Swanson and Jeffrey L. Melton, M.D. Last Updated: 1996-12-30 20:38:08 Created: 1996-12-30 18:57:48 Contact Us Jason R. Swanson Jeffrey L. Melton, M.D. Dermatology LUMEN Clinical Research Opportunities About LUMEN Dermatology Search for Derm Images More Dermatology Sites Other Medical Sites Other Links Loyola University Medical Center Stritch School of Medicine Medical Center Departments LUMEN Home Loyola University Chicago

37. Erythema Multiforme (2) erythema multiforme (2). Loyola University Medical Center. nonframe version Jason R. Swanson and Jeffrey L. Melton, MD. Last Updated 1996-12-30 203821 http://www.meddean.luc.edu/lumen/MedEd/medicine/dermatology/melton/erthmul2.htm

Erythema multiforme (2) non-frame version Jason R. Swanson and Jeffrey L. Melton, M.D. Last Updated: 1996-12-30 20:38:21 Created: 1996-12-30 18:59:32 Contact Us Jason R. Swanson Jeffrey L. Melton, M.D. Dermatology LUMEN Clinical Research Opportunities About LUMEN Dermatology Search for Derm Images More Dermatology Sites Other Medical Sites Other Links Loyola University Medical Center Stritch School of Medicine Medical Center Departments LUMEN Home Loyola University Chicago

38. ERYTHEMA MULTIFORME erythema multiforme I have a 67 year old woman who has now had her fourth episode of erythema multiforme http://dermatology.cdlib.org/rxderm-archives/erythema-multiforme

ERYTHEMA MULTIFORME - I have a 67 year old woman who has now had her fourth episode of erythema multiforme (bx twice, immunofluorescence pending). She takes no medications. Workup, including many viral and bacterial titers has been negative, but for moderately elevated varicella titers. HSV titers were normal. She has no clinically apparent infectious processes. Empirical trial of acyclovir failed to prevent the second episode of erythema multiforme. Suggestions ? Dapsone was cited in a Br.J. Derm. article a few years ago, I think. Michael Fetterman Before we were aware of EM caused by HSV, we gave patients one weeks worth of Prednisone. I think it was as low as thirty mg. They were given prn refills for the occasional recurrance. We also gave the same script to the recurrant apthous stomatitis patients. If course this was before I was educated about dexamethasone per Haines Ely! Diane Thaler Cyclosporine is THE remedy for erythema multiforme in my experience; and in particular is of value in TEN / Stevens-Johnson when the patient's problem has to be brought under control RIGHT NOW, and with a high probablity of success. Depending on severity and cost considerations I would of course try Valtrex, dapsone, etc. but when the chips are down I go straight to CyA - start at 5 - 10 mg / kg / day and then feel your way down after a few days or a week when things start to improve. KC Smith MD FRCPC Confession: I have never used CyA. Are there others out there who have the same problem? It seems to have replaced steroids in the armamentarium of some-especially our esteemed colleague, KC. How does one get comfortable Diane Thaler I have not used it either. I am concerned we will be treating dermatoses at the expense of our patient's kidneys. Jerry Eisner Having had the benefit of isolating the receptor for cyclosporin A at Yale with Professor Handschumacher in 1992, I went on to train at the University of Michigan which did alot of empirical clinical use of Cyclosporin. I used it mainly on the wards for severe and resistant dermatoses. It works for all sorts of severe inflammatory dermatoses better than other available therapies in many cases. It definitely belongs in our therapeutic armamentarium. I am not familiar with the therapeutic effects of a single bolus as KC has suggests. I did see a pustular psoriasis case at NYU on the rebound from Cyclosporin. The patient was self-regulating the dosage. Properly managed, cyclosporin has a lower side effect profile than glucocorticoids, especially on children. I will write a chapter on this drug and place it in the Electronic Textbook so that we can bring it into our online coversations more easily. I have used Dapsone, 100 mg po QD, effectively to control severe recurrent erythema multiforme. My patient was very happy for the success. Antimalarials also work. Rheett Drugge

39. Lupus Erythematosus And Erythema Multiforme:ANSWER This is much too long for erythema multiforme. Lupus erythematosus associated with erythema multiformelike lesions in identical twins. http://dermatology.cdlib.org/DOJvol3num2/cases/mendonca2.html

DIAGNOSIS: Rowell's Syndrome Discussion In 1963 Rowell et al. described a syndrome characterized by lupus erythematosus with erythema multiforme-like lesions,speckled antinuclear antibodies, anti-SjT antibodies and rheumatoid factor.(1) Anti- SjT is now thought to be identical with anti-La (SS-B). Rowell originally reported this syndrome in DLE(1) but it also occurs in SLE.(2) Perniotic lesions frequently occur.(3) Figure 7 Figure 7: Annular erythematous purpuric plaques on the arm. This case fulfills all the criteria described initially by Rowell et al. and by subsequent reports.(4-7) Although a positive rheumatoid factor has also been shown in many (but not all) cases reported thus far, this test was not obtained for our patient. This report does differ from previous descriptions of Rowell's syndrome in that the first biopsy was interpreted as erythema multiforme.(8) However, the second biopsy was consistent with lupus erythematosus. Some authors feel that Rowell syndrome may simply be coincidental occurrence of lupus erythematosus and erythema multiforme.(9)

40. Discovery Health :: Diseases & Conditions :: Erythema Multiforme erythema multiforme is a skin reaction that results in red, targetshaped patches on the skin. http://health.discovery.com/encyclopedias/illnesses.html?article=104&page=1

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