Materiały źródłowe

• #1 Erythema multiforme: Management – UpToDate

  https://www.uptodate.com/contents/erythema-multiforme-management

  Erythema multiforme (EM) is an acute, immune-mediated condition characterized by the appearance of distinctive, target-like lesions on the skin. These lesions are often accompanied by erosions or bullae involving the oral, genital, and/or ocular mucosae. „Erythema multiforme major” is the term used to describe EM with mucosal involvement (and may have associated systemic symptoms, such as fever and arthralgias). „Erythema multiforme minor” refers to EM without (or with only mild) mucosal disease and without associated systemic symptoms. […] The management of acute and recurrent EM will be reviewed here. The pathogenesis, clinical features, and diagnosis of this disorder are discussed separately. […] The management of EM is divided into interventions for acute episodes and interventions for suppression of recurrent disease. Treatments for acute episodes primarily aim to improve symptoms (eg, pain) and support resolution because acute episodes typically spontaneously resolve within two weeks. Involvement of the ocular mucosa is an exception; prompt intervention and close monitoring is advised to minimize risk for long-term complications.

• #1 Erythema Multiforme – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470259/

  Erythema multiforme is a self-limiting condition that usually resolves without significant complications; however, a limited number of cases become persistent. […] Management of acute erythema multiforme focuses on improving symptoms, managing pain, and supporting recovery, which usually happens within 2 weeks. Interventions for recurrent erythema multiforme aim to reduce or eliminate repeated disease episodes. […] The first step in managing erythema multiforme is to remove the underlying cause, eg, discontinuing the medication that could have triggered the reaction. […] Topical treatment for erythema multiforme includes antiseptics for bullous lesions, antiseptic mouthwashes, and anesthetic agents for pain relief. […] Hospitalization may be required for severe pain, dehydration, or difficulty eating.

• #1 Erythema Multiforme Treatment & Management: Approach Considerations, Medical Care, Hospitalization

  https://emedicine.medscape.com/article/1122915-treatment

  Mild cases of erythema multiforme (EM) require only symptomatic treatment in the emergency department (ED), which may include analgesics or nonsteroidal inflammatory drugs (NSAIDs); cold compresses with saline or Burrow solution; topical steroids; and soothing oral treatments (eg, saline gargles, viscous lidocaine, and diphenhydramine elixir). […] In the severe cases of EM major, aggressive monitoring and replacement of fluids and electrolytes as necessary are of paramount importance. Supportive respiratory care, including suctioning and postural drainage, should be provided as necessary. […] The cause of EM should be identified, if possible. If a drug is suspected, it must be withdrawn as soon as possible. This includes all medications begun during the preceding 2 months. All unnecessary medications should be discontinued.

• #1 Erythema Multiforme: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/24475-erythema-multiforme

  Erythema multiforme usually causes a painful or uncomfortable rash on your skin. This rash can start small but can increase in size over time. It can be itchy and cause raised bumps on your skin. Severe forms of erythema multiforme can affect your mouth and eyes, with symptoms that make it difficult for you to eat, drink and see. Depending on the severity, you may need to be treated in the hospital. Treatment helps alleviate symptoms to get you feeling better. […] Treatment for erythema multiforme isn’t always necessary, as symptoms can resolve on their own. If you need treatment, it could include: Using topical corticosteroids or oral antihistamines for itching. Using eye drops if symptoms affect your eyes. Applying topical anesthetics or oral numbing medicine for pain. Eating a soft or liquid diet if lesions in your mouth make eating difficult. Rinsing your mouth with a warm saltwater solution. Taking antibiotics or antiviral medications if you have an infection. Stopping a medication that causes erythema multiforme.

• #1 Erythema Multiforme: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/24475-erythema-multiforme

  Follow your provider’s treatment plan to reduce your symptoms. Try not to scratch your skin because your fingernails can scratch the lesions and break them open, which could cause an infection. To prevent itching, use a topical cream or ointment to soothe your skin. […] While it may be painful to eat or drink, make sure you eat and drink regularly to prevent malnutrition or dehydration. Change your diet to include liquids and/or soft foods. Avoid foods that are hot in temperature, acidic or spicy to prevent irritation. If you have trouble eating, contact your provider. […] Visit your healthcare provider if you experience symptoms of erythema multiforme that don’t clear up with treatment after four weeks or if you have frequent flares that affect your quality of life. Visit the emergency room if your symptoms affect a large area of your skin, eyes, mouth or the area on or around your genitals. Or if you have systemic symptoms such as fevers, nausea or joint pain.

• #1 Erythema Multiforme – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470259/

  Daily monitoring is essential for patients with extensive lesions to track progress and promptly address any complications. […] Herpes is the most common cause of recurrent erythema multiforme. […] Preventive therapy is indicated, in theory, for patients with more than 5 erythema multiforme outbreaks per year or fewer in the case of severe forms. […] Severe cases of erythema multiforme will require hospital admission to manage complications, dehydration, and infection, which are best handled in an intensive care facility. […] Nutritional support is vital, and total parenteral nutrition is an option if the patient has diarrhea. […] The effective management of erythema multiforme requires a coordinated, interprofessional approach to ensure optimal patient-centered care, safety, and outcomes. […] Nurses contribute to patient education on general skin care, ensuring treatment adherence, and monitoring symptom progression.

• #1 Erythema Multiforme – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/sites/books/NBK470259/

  Hospitalization may be required for severe pain, dehydration, or difficulty eating. […] Daily monitoring is essential for patients with extensive lesions to track progress and promptly address any complications. […] In recurrent cases, the focus is on managing acute symptoms and eliminating the triggering factor to prevent future episodes. […] Herpes is the most common cause of recurrent erythema multiforme. […] Preventive therapy is indicated, in theory, for patients with more than 5 erythema multiforme outbreaks per year or fewer in the case of severe forms. […] Severe cases of erythema multiforme will require hospital admission to manage complications, dehydration, and infection, which are best handled in an intensive care facility. […] The effective management of erythema multiforme requires a coordinated, interprofessional approach to ensure optimal patient-centered care, safety, and outcomes. […] Nurses contribute to patient education on general skin care, ensuring treatment adherence, and monitoring symptom progression.

• #1 Erythema Multiforme Treatment & Management: Approach Considerations, Medical Care, Hospitalization

  https://emedicine.medscape.com/article/1122915-treatment

  Prophylaxis for recurrence of herpes-associated EM (HAEM) should be considered in patients with more than five attacks per year. […] EM major may warrant hospitalization for the treatment of complications and sequelae (eg, in cases of severe mucous membrane involvement, impaired oral intake, dehydration, or secondary infection) and to manage the patient’s fluid and electrolytes. […] Care in a surgical specialty burn unit may provide the greatest likelihood of survival. […] During the healing process, which usually takes about 2 weeks, proper skin care is essential. […] Fluid resuscitation and nutritional support […] Several issues make nutritional support critical. A liquid diet and IV fluid therapy may be necessary. […] Fluid and electrolytes may be lost through the disrupted skin barrier, and widespread painful oral erosions may make feeding difficult.

• #1 Erythema Multiforme Treatment & Management: Approach Considerations, Medical Care, Hospitalization

  https://emedicine.medscape.com/article/1122915-treatment

  Infections should be appropriately treated after cultures or serologic tests have been performed. The use of liquid antiseptics (eg, 0.05% chlorhexidine) during bathing helps prevent superinfection. Topical treatment, including that for genital involvement, may be performed with a gauze dressing or a hydrocolloid. […] Local supportive care for eye involvement is important and includes topical lubricants for dry eyes, sweeping of conjunctival fornices, and removal of fresh adhesions. […] Analgesics should be administered as needed to control pain, which may be severe. Topical corticosteroids are useful for outpatient treatment of patients with limited disease. […] Systemic corticosteroid therapy is controversial in EM, and some believe it may predispose to complications. If given, the course should be limited to 10 days to 2 weeks.

• #1 Erythema Multiforme | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/21300

  Preventive therapy is indicated, in theory, for patients with more than 5 erythema multiforme outbreaks per year or fewer in the case of severe forms. […] Severe cases of erythema multiforme will require hospital admission to manage complications, dehydration, and infection, which are best handled in an intensive care facility. […] Nutritional support is vital, and total parenteral nutrition is an option if the patient has diarrhea. […] The effective management of erythema multiforme requires a coordinated, interprofessional approach to ensure optimal patient-centered care, safety, and outcomes. […] Nurses contribute to patient education on general skin care, ensuring treatment adherence, and monitoring symptom progression.

• #1 Erythema Multiforme – Dermatologic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/dermatologic-disorders/hypersensitivity-and-reactive-skin-disorders/erythema-multiforme

  Erythema multiforme is an inflammatory reaction, characterized by target or iris skin lesions. Oral mucosa may be involved. Diagnosis is clinical. Lesions spontaneously resolve but frequently recur. Erythema multiforme usually occurs as a reaction to an infectious agent such as herpes simplex virus or mycoplasma but may be a reaction to a medication. Suppressive antiviral therapy may be indicated for patients with frequent or symptomatic recurrence due to herpes simplex virus. […] Erythema multiforme spontaneously resolves, so treatment is usually unnecessary. Topical corticosteroids and anesthetics and oral antihistamines may ameliorate symptoms and reassure patients, but sometimes antivirals are needed. […] Treat erythema multiforme supportively and consider prophylactic antiviral medications if HSV is the suspected cause and recurrences are frequent.

• #1 Erythema multiforme

  https://www.pcds.org.uk/clinical-guidance/erythema-multiforme

  EM is self-limiting, usually resolving without complications, and is now regarded as distinct from Stevens-Johnson syndrome and toxic epidermal necrolysis. […] Supportive treatment is all that is required for the majority. […] In more severe cases, eg EM major, hospital admission is usually required for intensive nursing care. The role of systemic steroids remains controversial. […] Recurrent EM secondary to herpes simplex should be treated with prophylactic oral aciclovir. The standard adult dose is 400 mg BD, in children the dose is 10 mg/kg/day in divided doses. Even in patients where herpes simplex appears absent, if attacks are multiple consider prophylactic aciclovir as some cases of herpes simplex are believed to be subclinical. Patients may require prophylactic treatment for 1-2 years or longer.

• #1 Erythema multiforme – BAD Patient Hub

  https://www.skinhealthinfo.org.uk/condition/erythema-multiforme/

  Erythema multiforme (EM) is a hypersensitivity reaction (when the immune system mistakenly identifies a harmless substance as harmful) which tends to develop suddenly. […] EM is usually mild – 'erythema multiforme minor’ with only the skin affected and clearing up in days to weeks. […] If a particular medication is suspected, it should be stopped straight away. If an infectious cause is found, it should be treated. […] Mild rashes will clear up in a few weeks spontaneously. Moisturisers and topical corticosteroids can be prescribed to speed up recovery and reduce symptoms of itch or burn. […] Severe rashes: Patients may need to be nursed in hospital as the skin may need regular dressings, pain relief and fluid and salt replacement. […] If the rash involves the mouth, regular mouth opening exercises can be beneficial. […] If you have had one attack of EM, remember there is a risk that you will have another. […] If your attacks follow cold sores, you may want to ask your doctor about taking antiviral tablets long-term.

• #1

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=abq3276

  Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take. […] If itching is a problem: Put a cool, moist cloth on the rash. Try an over-the-counter antihistamine. Be safe with medicines. Read and follow all instructions on the label. […] For pain from mouth sores, try rinsing regularly with an over-the-counter mouthwash for mouth sores. […] If your doctor prescribed medicine, take it exactly as prescribed. Call your doctor or nurse advice line if you think you are having a problem with your medicine. […] Call your doctor or nurse advice line now or seek immediate medical care if: You have a new rash that affects your eyes, mouth, or genitals. You have a fever or chills. […] Watch closely for changes in your health, and be sure to contact your doctor or nurse advice line if: Your rash is changing or getting worse. You do not get better as expected.

• #1 Erythema Multiforme (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/erythema-multiforme.html

  If your child is diagnosed with erythema multiforme, call the doctor if your child has any of these problems: spots in the mouth or lips, spots around the eyes or the white part of the eyes look red, trouble drinking liquids, pain that doesn’t get better with pain medicine, peeling skin. […] It can be hard to wait until the rash goes away. You can help your child by treating the itching and pain and calling the doctor if you think your child is getting worse.

• #1 Erythema multiforme: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000851.htm

  Erythema multiforme (EM) is an acute skin reaction that comes from an infection or another trigger. EM is a self-limiting condition. This means it usually resolves on its own without treatment. […] EM usually goes away on its own with or without treatment. […] Your provider will have you stop taking any medicines that may be causing the problem. But, don’t stop taking medicines on your own without talking to your provider first. […] Good hygiene may help prevent secondary infections (infections that occur from treating the first infection). […] Use of sunscreen, protective clothing, and avoiding excessive exposure to sun may prevent the recurrence of EM. […] Contact your provider right away if you have symptoms of EM.

• #1 Erythema Multiforme Treatment & Management: Approach Considerations, Medical Care, Hospitalization

  https://emedicine.medscape.com/article/1122915-treatment

  The adequacy of fluid resuscitation should be monitored by using a urinary bladder catheter. […] Patients with tracheobronchial involvement may present with hyperventilation and mild hypoxemia. Careful monitoring and aggressive pulmonary support may lead to early detection and treatment of diffuse interstitial pneumonitis and thus prevent the development of acute respiratory distress syndrome (ARDS). […] If the patient was hospitalized, the medical professional(s) who provided treatment during that time should see the patient regularly and provide symptomatic relief as needed. […] The affected skin should be protected from any pressure or shear forces. […] Once EM due to a drug has been diagnosed, the patient should never be rechallenged with the same drug or any other drug of the same class or similar chemical structure.

• #2 Erythema Multiforme – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/sites/books/NBK470259/

  Erythema multiforme is a self-limiting condition that usually resolves without significant complications; however, a limited number of cases become persistent. […] Management of acute erythema multiforme focuses on improving symptoms, managing pain, and supporting recovery, which usually happens within 2 weeks. […] The treatment approaches of erythema multiforme can be divided into strategies for acute episodes and suppressing recurrent disease. Supportive measures can treat acute episodes, aiming to reduce the patient’s burden of symptoms until the natural resolution occurs, usually in 2 weeks. […] The first step in managing erythema multiforme is to remove the underlying cause, eg, discontinuing the medication that could have triggered the reaction. […] Topical treatment for erythema multiforme includes antiseptics for bullous lesions, antiseptic mouthwashes, and anesthetic agents for pain relief.

• #2 Erythema Multiforme Treatment & Management: Approach Considerations, Medical Care, Hospitalization

  https://emedicine.medscape.com/article/1122915-treatment

  Infections should be appropriately treated after cultures or serologic tests have been performed. The use of liquid antiseptics (eg, 0.05% chlorhexidine) during bathing helps prevent superinfection. Topical treatment, including that for genital involvement, may be performed with a gauze dressing or a hydrocolloid. […] Local supportive care for eye involvement is important and includes topical lubricants for dry eyes, sweeping of conjunctival fornices, and removal of fresh adhesions. […] Analgesics should be administered as needed to control pain, which may be severe. Topical corticosteroids are useful for outpatient treatment of patients with limited disease. […] Systemic corticosteroid therapy is controversial in EM, and some believe it may predispose to complications. If given, the course should be limited to 10 days to 2 weeks.

• #2 Erythema Multiforme Treatment & Management: Approach Considerations, Medical Care, Hospitalization

  https://emedicine.medscape.com/article/1122915-treatment

  Mild cases of erythema multiforme (EM) require only symptomatic treatment in the emergency department (ED), which may include analgesics or nonsteroidal inflammatory drugs (NSAIDs); cold compresses with saline or Burrow solution; topical steroids; and soothing oral treatments (eg, saline gargles, viscous lidocaine, and diphenhydramine elixir). […] In the severe cases of EM major, aggressive monitoring and replacement of fluids and electrolytes as necessary are of paramount importance. Supportive respiratory care, including suctioning and postural drainage, should be provided as necessary. […] The cause of EM should be identified, if possible. If a drug is suspected, it must be withdrawn as soon as possible. This includes all medications begun during the preceding 2 months. All unnecessary medications should be discontinued.

• #2 Erythema Multiforme: Care Instructions | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.erythema-multiforme-care-instructions.abq3276

  If itching is a problem: Put a cool, moist cloth on the rash. Try an over-the-counter antihistamine. Be safe with medicines. Read and follow all instructions on the label. […] For pain from mouth sores, try rinsing regularly with an over-the-counter mouthwash for mouth sores. […] If your doctor prescribed medicine, take it exactly as prescribed. Call your doctor if you think you are having a problem with your medicine. […] Call your doctor now or seek immediate medical care if: You have a new rash that affects your eyes, mouth, or genitals. You have a fever or chills. […] Watch closely for changes in your health, and be sure to contact your doctor if: Your rash is changing or getting worse. You do not get better as expected.

• #2 Erythema multiforme – BAD Patient Hub

  https://www.skinhealthinfo.org.uk/condition/erythema-multiforme/

  Erythema multiforme (EM) is a hypersensitivity reaction (when the immune system mistakenly identifies a harmless substance as harmful) which tends to develop suddenly. […] EM is usually mild – 'erythema multiforme minor’ with only the skin affected and clearing up in days to weeks. […] If a particular medication is suspected, it should be stopped straight away. If an infectious cause is found, it should be treated. […] Mild rashes will clear up in a few weeks spontaneously. Moisturisers and topical corticosteroids can be prescribed to speed up recovery and reduce symptoms of itch or burn. […] Severe rashes: Patients may need to be nursed in hospital as the skin may need regular dressings, pain relief and fluid and salt replacement. […] If the rash involves the mouth, regular mouth opening exercises can be beneficial. […] If you have had one attack of EM, remember there is a risk that you will have another. […] If your attacks follow cold sores, you may want to ask your doctor about taking antiviral tablets long-term.

• #2 Erythema Multiforme Treatment & Management: Approach Considerations, Medical Care, Hospitalization

  https://emedicine.medscape.com/article/1122915-treatment

  Prophylaxis for recurrence of herpes-associated EM (HAEM) should be considered in patients with more than five attacks per year. […] EM major may warrant hospitalization for the treatment of complications and sequelae (eg, in cases of severe mucous membrane involvement, impaired oral intake, dehydration, or secondary infection) and to manage the patient’s fluid and electrolytes. […] Care in a surgical specialty burn unit may provide the greatest likelihood of survival. […] During the healing process, which usually takes about 2 weeks, proper skin care is essential. […] Fluid resuscitation and nutritional support […] Several issues make nutritional support critical. A liquid diet and IV fluid therapy may be necessary. […] Fluid and electrolytes may be lost through the disrupted skin barrier, and widespread painful oral erosions may make feeding difficult.

• #2 Management of Erythema Multiforme in the Urgent Care Setting – Journal of Urgent Care Medicine

  https://www.jucm.com/management-of-erythema-multiforme-in-the-urgent-care-setting/

  Patients with severe cases should be admitted to a burn unit. Dehydration may also be severe. The clinician should be vigilant in monitoring electrolyte imbalances. Antibiotics may be necessary if secondary infection of lesions is suspected. […] In mild cases, cold compresses and topical steroids can be used. Severe skin lesions should be treated as heat burns; 5% aluminum subacetate (Domeboro) solutions should be used and nonadherent dressings should be applied. […] Systemic corticosteroids may be considered in severe cases, though their use remains controversial. A one- to three-week course of prednisone is usually used. Prednisone (40 mg/day to 80 mg/day) is continued until control is achieved and is then tapered rapidly over a week. Treatment with prednisone may be successful in aborting a recurrence.

• #2 Recent Updates in the Treatment of Erythema Multiforme

  https://www.mdpi.com/1648-9144/57/9/921

  Erythema multiforme (EM) is an immune-mediated condition that classically presents with discrete targetoid lesions and can involve both mucosal and cutaneous sites. […] Treatment of EM is highly variable, depending on the etiology, the involvement of mucosal sites, and the chronicity (acute vs. recurring) of the disease. If the etiology or causal medication/infection is identified, then the medication is stopped and/or the infection is treated prior to initiating symptomatic treatment. Treatment for acute EM is focused on relieving symptoms with topical steroids or antihistamines. […] Treatment for recurrent EM is most successful when tailored to individual patients. First line treatment for recurrent EM includes both systemic and topical therapies. Systemic therapies include corticosteroid therapy and antiviral prophylaxis. Topical therapies include high-potency corticosteroids, and antiseptic or anesthetic solutions for mucosal involvement.

• #2 Recent Updates in the Treatment of Erythema Multiforme

  https://www.mdpi.com/1648-9144/57/9/921

  In acute disease, treatment is rarely needed as the lesions will typically regress over the course of several weeks, and supportive treatment is focused on improving symptoms. […] In recurrent EM, treatment focuses on addressing the etiology through systemic antiviral prophylactic therapy. […] In severe disease with extensive mucosal involvement, hospitalization is generally recommended due to limited oral intake. Administration of intravenous fluids and electrolyte replacement are recommended. Additionally, systemic glucocorticoid therapy may be used, most commonly, prednisone 40–60 mg/d, tapered over 2–4 weeks. […] Current recommendations include acyclovir, 400 mg, twice daily, valacyclovir, 500 mg, twice daily, or famciclovir, 250 mg, twice daily. […] Patients with recurrent EM that are unresponsive to antiviral therapy can try other antiviral drugs or double the dosage of the current drug. Additionally, other systemic agents may be used. […] Treatment options must be carefully weighed, considering the various adverse effects that are possible with each therapy and their variable efficacies.

• #2 Erythema multiforme

  https://www.pcds.org.uk/clinical-guidance/erythema-multiforme

  EM is self-limiting, usually resolving without complications, and is now regarded as distinct from Stevens-Johnson syndrome and toxic epidermal necrolysis. […] Supportive treatment is all that is required for the majority. […] In more severe cases, eg EM major, hospital admission is usually required for intensive nursing care. The role of systemic steroids remains controversial. […] Recurrent EM secondary to herpes simplex should be treated with prophylactic oral aciclovir. The standard adult dose is 400 mg BD, in children the dose is 10 mg/kg/day in divided doses. Even in patients where herpes simplex appears absent, if attacks are multiple consider prophylactic aciclovir as some cases of herpes simplex are believed to be subclinical. Patients may require prophylactic treatment for 1-2 years or longer.

• #2 Erythema Multiforme | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/21300

  Preventive therapy is indicated, in theory, for patients with more than 5 erythema multiforme outbreaks per year or fewer in the case of severe forms. […] Severe cases of erythema multiforme will require hospital admission to manage complications, dehydration, and infection, which are best handled in an intensive care facility. […] Nutritional support is vital, and total parenteral nutrition is an option if the patient has diarrhea. […] The effective management of erythema multiforme requires a coordinated, interprofessional approach to ensure optimal patient-centered care, safety, and outcomes. […] Nurses contribute to patient education on general skin care, ensuring treatment adherence, and monitoring symptom progression.

• #2 Erythema Multiforme – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/sites/books/NBK470259/

  Hospitalization may be required for severe pain, dehydration, or difficulty eating. […] Daily monitoring is essential for patients with extensive lesions to track progress and promptly address any complications. […] In recurrent cases, the focus is on managing acute symptoms and eliminating the triggering factor to prevent future episodes. […] Herpes is the most common cause of recurrent erythema multiforme. […] Preventive therapy is indicated, in theory, for patients with more than 5 erythema multiforme outbreaks per year or fewer in the case of severe forms. […] Severe cases of erythema multiforme will require hospital admission to manage complications, dehydration, and infection, which are best handled in an intensive care facility. […] The effective management of erythema multiforme requires a coordinated, interprofessional approach to ensure optimal patient-centered care, safety, and outcomes. […] Nurses contribute to patient education on general skin care, ensuring treatment adherence, and monitoring symptom progression.

• #2 Erythema Multiforme | Consultant360

  https://www.consultant360.com/articles/erythema-multiforme

  Hospital course. A dermatologist was consulted to evaluate erythema multiforme (EM) versus Stevens-Johnson syndrome (SJS). The patient was started on empiric intravenous acyclovir out of concern for HSV infection, as well as methylprednisolone sodium succinate injection for suspected drug reaction. […] On day 2 of admission, the patients oral and cutaneous lesions started to improve. A skin biopsy showed focal epidermal necrosis and superficial and perivascular infiltrate, consistent with EM. She was started on artificial tears and Lacri-Lube eye ointment, magic mouthwash (aluminum hydroxide/magnesiumhydroxide/simethicone/diphenhydramine/lidocaine) for mucositis and odynophagia, mupirocin for the open cutaneous lesions, and topical lidocaine and betamethasone dipropionate for the vaginal lesions.

• #2 Erythema Multiforme in Children: Care Instructions | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.erythema-multiforme-in-children-care-instructions.abq3996

  For itching: Put a cool, moist cloth on the rash. Try an over-the-counter antihistamine. Don’t give antihistamines to your child unless you’ve checked with the doctor first. Be safe with medicines. Read and follow all instructions on the label. […] If your child is having pain from mouth sores and is old enough to use a mouthwash, have your child rinse their mouth regularly with an over-the-counter mouthwash for mouth sores. […] If your doctor prescribed medicine, have your child take it exactly as prescribed. Call your doctor if you think your child is having a problem with a medicine. […] Call your doctor now or seek immediate medical care if: Your child has a new rash that affects the eyes, mouth, or genitals. Your child has a fever or chills. […] Watch closely for changes in your child’s health, and be sure to contact your doctor if: Your child’s rash is changing or getting worse. Your child does not get better as expected.

• #2 Erythema Multiforme: Care Instructions | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.erythema-multiforme-care-instructions.abq3276

  Erythema multiforme (say „air-uh-THEE-muh mul-tuh-FOR-mee”) is a rash that often causes red spots. These spots can look like targets, with a circle around the edge and a darker area in the center. […] This skin condition is usually found on the hands, feet, arms, or legs. But it can affect any part of the body. This includes the mouth, the eyes, and the genitals. Sometimes, the rash itches or burns. Some people have a fever or feel a little sick. […] In most cases, the rash goes away on its own in a few weeks. In some people, the rash returns. Treatment can include medicines for itching and mouth pain. […] Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take.

• #2

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=abq3996

  Follow-up care is a key part of your child’s treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if your child is having problems. It’s also a good idea to know your child’s test results and keep a list of the medicines your child takes. […] For itching: Put a cool, moist cloth on the rash. Try an over-the-counter antihistamine. Don’t give antihistamines to your child unless you’ve checked with the doctor first. Be safe with medicines. Read and follow all instructions on the label. […] If your child is having pain from mouth sores and is old enough to use a mouthwash, have your child rinse their mouth regularly with an over-the-counter mouthwash for mouth sores. […] If your doctor prescribed medicine, have your child take it exactly as prescribed. Call your doctor or nurse advice line if you think your child is having a problem with a medicine.

• #2 Erythema Multiforme – Dermatologic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/dermatologic-disorders/hypersensitivity-and-reactive-skin-disorders/erythema-multiforme

  Erythema multiforme is an inflammatory reaction, characterized by target or iris skin lesions. Oral mucosa may be involved. Diagnosis is clinical. Lesions spontaneously resolve but frequently recur. Erythema multiforme usually occurs as a reaction to an infectious agent such as herpes simplex virus or mycoplasma but may be a reaction to a medication. Suppressive antiviral therapy may be indicated for patients with frequent or symptomatic recurrence due to herpes simplex virus. […] Erythema multiforme spontaneously resolves, so treatment is usually unnecessary. Topical corticosteroids and anesthetics and oral antihistamines may ameliorate symptoms and reassure patients, but sometimes antivirals are needed. […] Treat erythema multiforme supportively and consider prophylactic antiviral medications if HSV is the suspected cause and recurrences are frequent.

• #2 Erythema multiforme: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000851.htm

  Erythema multiforme (EM) is an acute skin reaction that comes from an infection or another trigger. EM is a self-limiting condition. This means it usually resolves on its own without treatment. […] EM usually goes away on its own with or without treatment. […] Your provider will have you stop taking any medicines that may be causing the problem. But, don’t stop taking medicines on your own without talking to your provider first. […] Good hygiene may help prevent secondary infections (infections that occur from treating the first infection). […] Use of sunscreen, protective clothing, and avoiding excessive exposure to sun may prevent the recurrence of EM. […] Contact your provider right away if you have symptoms of EM.

• #2 Erythema multiforme

  https://adamcertificationdemo.adam.com/content.aspx?productid=141&pid=1&gid=000851

  Erythema multiforme (EM) is an acute skin reaction that comes from an infection or another trigger. EM is a self-limiting condition. This means it usually resolves on its own without treatment. […] EM usually goes away on its own with or without treatment. […] Your provider will have you stop taking any medicines that may be causing the problem. But, don’t stop taking medicines on your own without talking to your provider first. […] Treatment may include: Medicines, such as antihistamines, to control itching; Moist compresses applied to the skin; Pain medicines to reduce fever and discomfort; Mouthwashes to ease discomfort of mouth sores that interferes with eating and drinking; Antibiotics for skin infections; Corticosteroids to control inflammation; Medicines for eye symptoms. […] Good hygiene may help prevent secondary infections (infections that occur from treating the first infection). […] Use of sunscreen, protective clothing, and avoiding excessive exposure to sun may prevent the recurrence of EM.

• #2

  https://www.nursingcenter.com/cearticle?an=01412499-202411000-00004&Journal_ID=849729&Issue_ID=7215373

  Erythema multiforme is an acute, immune-mediated, mucocutaneous disorder that is frequently associated with herpes simplex virus. This condition is subdivided into two classifications: erythema multiforme minor and erythema multiforme major. […] This review will discuss the epidemiology, pathophysiology, diagnosis, and management of erythema multiforme so that dermatology nurses and providers are better able to identify and manage this disease.

• #2 Erythema multiforme – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-us/367

  Erythema multiforme is typically a mild, self-limiting, potentially recurring mucocutaneous inflammatory condition. […] Supportive care and treatment of underlying infection/withdrawal of the offending drug remain the mainstay of therapy. […] This can lead to difficulty eating and urinating, requiring hospitalisation.

• #3 Erythema Multiforme (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/erythema-multiforme.html

  Erythema multiforme goes away on its own. If the cause is an infection, the doctor may treat that. If a medicine was the cause, the doctor will stop it and use a new one if a medicine is still needed. […] To help make kids feel better, doctors may suggest: putting cool packs on the rash, taking a cool bath or shower, using acetaminophen (like Tylenol or a store brand) for pain or fever, using antihistamines (like Benadryl, Claritin, Zyrtec, or store brands), putting creams on the skin to help with itchiness. […] These treatments won’t make the rash go away faster, but will make a child feel better until the rash is gone. […] Call the doctor if you think your child has erythema multiforme. Other rashes due to more serious illness can look similar, so your doctor should check the rash.

• #3 Erythema multiforme – WikEM

  https://wikem.org/wiki/Erythema_multiforme

  Erythema Multiforme (EM) is an acute, self-limited skin condition […] Management includes searching for the underlying cause and prompt withdrawal of the suspected drug/agent causing symptoms. Symptomatic treatment may involve systemic corticosteroids, oral antihistamines, analgesics, and local skin care. If there is oral involvement, soothing mouth washes are recommended, and for eye involvement, topical lubricants, cleaning of conjunctiva, and removal of fresh adhesions may be necessary. Mild cases with localized lesions may consider topical corticosteroids. […] For severe cases with multiple lesions or severe mucous membrane or tracheobronchial involvement with impaired PO intake, dehydration, or secondary infection, inpatient admission may be required, and specialized ICU or burn unit care may be necessary.

• #3 Management of Erythema Multiforme in the Urgent Care Setting – Journal of Urgent Care Medicine

  https://www.jucm.com/management-of-erythema-multiforme-in-the-urgent-care-setting/

  Patients with severe cases should be admitted to a burn unit. Dehydration may also be severe. The clinician should be vigilant in monitoring electrolyte imbalances. Antibiotics may be necessary if secondary infection of lesions is suspected. […] In mild cases, cold compresses and topical steroids can be used. Severe skin lesions should be treated as heat burns; 5% aluminum subacetate (Domeboro) solutions should be used and nonadherent dressings should be applied. […] Systemic corticosteroids may be considered in severe cases, though their use remains controversial. A one- to three-week course of prednisone is usually used. Prednisone (40 mg/day to 80 mg/day) is continued until control is achieved and is then tapered rapidly over a week. Treatment with prednisone may be successful in aborting a recurrence.

• #3 Erythema multiforme – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/erythema-multiforme/

  Patients with erythema multiforme major and severe oral mucosal involvement may suffer from dehydration and/or electrolyte abnormalities due to insufficient intake of liquids and food. […] Most patients with erythema multiforme minor require no specific treatment because the condition is self-limited. […] Pharmacotherapy (e.g., antivirals, systemic glucocorticoids) is recommended in patients with recurrent erythema multiforme to prevent further episodes. […] Systemic glucocorticoids should be considered in patients with erythema multiforme major with severe mucosal involvement.

• #3 Erythema Multiforme – Dermatologic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/dermatologic-disorders/hypersensitivity-and-reactive-skin-disorders/erythema-multiforme

  Erythema multiforme is an inflammatory reaction, characterized by target or iris skin lesions. Oral mucosa may be involved. Diagnosis is clinical. Lesions spontaneously resolve but frequently recur. Erythema multiforme usually occurs as a reaction to an infectious agent such as herpes simplex virus or mycoplasma but may be a reaction to a medication. Suppressive antiviral therapy may be indicated for patients with frequent or symptomatic recurrence due to herpes simplex virus. […] Erythema multiforme spontaneously resolves, so treatment is usually unnecessary. Topical corticosteroids and anesthetics and oral antihistamines may ameliorate symptoms and reassure patients, but sometimes antivirals are needed. […] Treat erythema multiforme supportively and consider prophylactic antiviral medications if HSV is the suspected cause and recurrences are frequent.

• #3

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=abq3996

  Call your doctor or nurse advice line now or seek immediate medical care if: Your child has a new rash that affects the eyes, mouth, or genitals. Your child has a fever or chills. […] Watch closely for changes in your child’s health, and be sure to contact your doctor or nurse advice line if: Your child’s rash is changing or getting worse. Your child does not get better as expected.

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