Erythema multiforme treatment steroids

Patients experience a mild, brief illness; complaints include fever, malaise, headache, and pruritus. The characteristic erythema appears about 10 days later. Facial redness is similar to that which occurs when a child is slapped; however, circumoral redness is absent. Several days following initial erythema, a less distinct rash may appear on the extremities and trunk. The rash usually resolves within 1 week but may occur for several weeks when the patient is exposed to heat, cold, exercise, or stress. Adults may also experience arthralgia and arthritis although these symptoms are less common in children. In addition, mild transient anemia, thrombocytopenia, and leukopenia may develop.

The central nervous system (CNS) is the most common site of extracutaneous involvement in children. Cerebellar ataxia is the most frequently encountered syndrome. Other possible CNS complications include encephalitis, meningitis, transverse myelitis and, rarely, Reye's syndrome (especially subsequent to aspirin use). Varicella pneumonia and encephalitis can be serious complications in adults. Additional rare complications in children and adults include myocarditis, corneal lesions, nephritis, arthritis, bleeding diatheses, acute glomerulonephritis and hepatitis. 1 , 2 , 7 , 21

Recurrent erythema multiforme is usually treated initially with continuous oral aciclovir for 6 months at a dose of 10 mg/kg/d in divided doses (eg, 400 mg twice daily), even if HSV has not been an obvious trigger for the patient's erythema multiforme. This has been shown to be effective in placebo-controlled double blind studies. However, erythema multiforme may recur when the aciclovir is ceased. Other antiviral drugs such as valciclovir (500–1000 mg/d) and famciclovir (250 mg twice daily) should be tried if aciclovir has not helped; these drugs are not readily available in New Zealand.

  • Urticaria, also known as hives, is common, and affects about 20% of people (one in 5 people) at some point in their lives. Urticaria consists of pink or white raised areas of skin resembling nettle rash, known as wheals (also spelled weals), which are usually itchy.  The wheals are often round or ring-shaped. Wheals can also appear as lines when the skin is firmly stroked. They can appear anywhere on the skin. Individual wheals typically disappear of their own accord within 24 hours without a trace, although the course of the condition is longer.  
  • Angioedema is characterised by deeper swelling in the skin, which may take over 24 hours to clear. It is not usually itchy and can affect the lips and tongue. Some patients have one or the other condition, others have both.

Erythema multiforme treatment steroids

erythema multiforme treatment steroids

  • Urticaria, also known as hives, is common, and affects about 20% of people (one in 5 people) at some point in their lives. Urticaria consists of pink or white raised areas of skin resembling nettle rash, known as wheals (also spelled weals), which are usually itchy.  The wheals are often round or ring-shaped. Wheals can also appear as lines when the skin is firmly stroked. They can appear anywhere on the skin. Individual wheals typically disappear of their own accord within 24 hours without a trace, although the course of the condition is longer.  
  • Angioedema is characterised by deeper swelling in the skin, which may take over 24 hours to clear. It is not usually itchy and can affect the lips and tongue. Some patients have one or the other condition, others have both.

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