Erythema Multiforme

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KEY POINTS

• Erythema multiforme is a kind of allergic reaction that causes a mild to severe rash.
• Stevens Johnson Syndrome is the severe form where you may have blisters all over your body as well as in your mouth and throat.
• Erythema multiforme is treated with medicine. If the rash is severe you may need to stay in the hospital.

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What is erythema multiforme?

Erythema multiforme (EM) is a kind of allergic reaction with a rash that can range from red, swollen spots to large blisters, usually on the arms or legs.

Stevens-Johnson syndrome (SJS) is a severe form of EM that causes symptoms in the mouth, throat, eyes, and on the genitals. You may or may not have a typical EM rash on the rest of your body. SJS can make you very sick, and in rare cases, it can be life-threatening.

What is the cause?

EM is usually a reaction to infections, such as those caused by mycoplasma bacteria, which causes lung infections, or the herpes simplex virus. Herpes simplex causes cold sores, sexually transmitted diseases, or eye infections. About half the time the cause is unknown. SJS is usually a reaction to some medicines, such as penicillin, sulfa drugs, antidepressants, and seizure medicines.

What are the symptoms?

The rash usually starts suddenly. The rash may start as red spots on the skin, especially on the backs of the arms, hands, fronts of the legs, and feet. The rash often causes red rings with a grayish center. You may have blisters, peeling skin, or sores on your skin, eyes, mouth, throat, or genitals.

Other symptoms may include:

• Fever and chills
• Headache
• Feeling tired
• Joint aches
• Itching, pain or dryness of the eyes

Usually the rash does not itch.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. Your provider will ask about medicines you have taken recently.

Usually your healthcare provider can diagnose EM by looking at the rash. You may have a skin biopsy to remove a sample of tissue for testing.

How is it treated?

Treatment depends on the cause, and on how severe your symptoms are. If an infection is the cause, you will be given medicine to treat the infection. If a medicine may be the cause, you will need to stop taking the medicine.

Mild symptoms may be treated with medicine for pain or fever and steroid cream for swelling and irritation.

In severe cases, especially SJS, you may need to stay in the hospital.

How can I help prevent EM and SJS?

Once you have had this problem, it may come back, even after treatment. You may be able to stop it from happening again if you:

• Avoid taking the medicine that caused it.
• Treat infections as soon as you start having symptoms.