World Library  
Flag as Inappropriate
Email this Article

Erythema multiforme

Erythema multiforme
Erythema multiforme minor of the hands (note the blanching centers of the lesion)
Classification and external resources
Specialty Dermatology
ICD-10 L51
ICD-9-CM 695.1
DiseasesDB 4450
MedlinePlus 000851
eMedicine derm/137
MeSH D004892

Erythema multiforme is a skin condition of unknown cause, possibly mediated by deposition of immune complex (mostly IgM) in the superficial microvasculature of the skin and oral mucous membrane that usually follows an infection or drug exposure. It is an uncommon disorder, with peak incidence in the second and third decades of life.


  • Signs and symptoms 1
  • Causes 2
  • Treatment 3
  • See also 4
  • References 5

Signs and symptoms

The condition varies from a mild, self-limited rash (E. multiforme minor)[1] to a severe, life-threatening form known as erythema multiforme major (or erythema multiforme majus) that also involves mucous membranes.

Consensus classification:[2]

  • Erythema multiforme minor—typical targets or raised, edematous papules distributed acrally
  • Erythema multiforme major—typical targets or raised, edematous papules distributed acrally with involvement of one or more mucous membranes; epidermal detachment involves less than 10% of total body surface area (TBSA)
  • SJS/TEN—widespread blisters predominant on the trunk and face, presenting with erythematous or pruritic macules and one or more mucous membrane erosions; epidermal detachment is less than 10% TBSA for Stevens-Johnson syndrome and 30% or more for toxic epidermal necrolysis.

The mild form usually presents with mildly itchy (but itching can be very severe), pink-red blotches, symmetrically arranged and starting on the extremities. It often takes on the classical "target lesion" appearance,[3] with a pink-red ring around a pale center. Resolution within 7–10 days is the norm.

Individuals with persistent (chronic) erythema multiforme will often have a lesion form at an injury site, e.g. a minor scratch or abrasion, within a week. Irritation or even pressure from clothing will cause the erythema sore to continue to expand along its margins for weeks or months, long after the original sore at the center heals.

Erythema multiforme reaction to an antibiotic 
"Erythema multiforme major" (Stevens–Johnson syndrome); which resembles "erythema multiforme" 
Target lesion 
Erythema Multiforme target lesions on the leg 


Many suspected aetiologic factors have been reported to cause EM.[4]

EM minor is regarded as being triggered by HSV in almost all cases.[3] A herpetic aetiology also accounts for 55% of cases of EM major.[3] Among the other infections, Mycoplasma infection appears to be a common cause.

Herpes simplex virus suppression and even prophylaxis (with acyclovir) has been shown to prevent recurrent erythema multiforme eruption.


Erythema multiforme is frequently self-limiting and requires no treatment. The appropriateness of glucocorticoid therapy can be uncertain, because it is difficult to determine if the course will be a resolving one.[5]

See also


  1. ^ "erythema multiforme" at Dorland's Medical Dictionary
  2. ^ Erythema Multiforme at eMedicine
  3. ^ a b c Lamoreux MR, Sternbach MR, Hsu WT (December 2006). "Erythema multiforme". Am Fam Physician 74 (11): 1883–8.  
  4. ^ "Erythema Multiforme". Pubmed Health. Retrieved 28 November 2012. 
  5. ^ Yeung AK, Goldman RD (November 2005). "Use of steroids for erythema multiforme in children". Can Fam Physician 51 (11): 1481–3.  
This article was sourced from Creative Commons Attribution-ShareAlike License; additional terms may apply. World Heritage Encyclopedia content is assembled from numerous content providers, Open Access Publishing, and in compliance with The Fair Access to Science and Technology Research Act (FASTR), Wikimedia Foundation, Inc., Public Library of Science, The Encyclopedia of Life, Open Book Publishers (OBP), PubMed, U.S. National Library of Medicine, National Center for Biotechnology Information, U.S. National Library of Medicine, National Institutes of Health (NIH), U.S. Department of Health & Human Services, and, which sources content from all federal, state, local, tribal, and territorial government publication portals (.gov, .mil, .edu). Funding for and content contributors is made possible from the U.S. Congress, E-Government Act of 2002.
Crowd sourced content that is contributed to World Heritage Encyclopedia is peer reviewed and edited by our editorial staff to ensure quality scholarly research articles.
By using this site, you agree to the Terms of Use and Privacy Policy. World Heritage Encyclopedia™ is a registered trademark of the World Public Library Association, a non-profit organization.

Copyright © World Library Foundation. All rights reserved. eBooks from Project Gutenberg are sponsored by the World Library Foundation,
a 501c(4) Member's Support Non-Profit Organization, and is NOT affiliated with any governmental agency or department.