Erythema multiforme
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Clinic
- EM is a skin condition that appears with red patches evolving into target lesions, typically on both hands.
- It is a type of erythema possibly mediated by deposition of immune complexes (mostly IgM-bound complexes) in the superficial microvasculature of the skin and oral mucous membrane that usually follows an infection or drug exposure.
- The condition varies from a mild, self-limited rash to a severe, life-threatening form known as erythema multiforme major that also involves mucous membranes. Consensus classification:
Causes
- Bacterial ( Bacillus Calmette–Guérin (BCG) vaccination, haemolytic Streptococci, legionellosis, leprosy, Neisseria meningitidis, Mycobacterium, Pneumococcus, Salmonella species, Staphylococcus species, Mycoplasma pneumoniae(More common), chlamydial.
- Fungal (Coccidioides immitis)
- Parasitic (Trichomonas species, Toxoplasma gondii),
- Viral (esp HSV-1, HSV-2) (55% of cases)
- Drug reactions,
- Physical factors: radiotherapy, cold, sunlight
- Others: collagen diseases, vasculitides, non-Hodgkin lymphoma, leukaemia, multiple myeloma, myeloid metaplasia, polycythemia
Related disease
- Stevens–Johnson syndrome