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Erythema multiforme(EM)

MedGen UID:
4527
Concept ID:
C0014742
Disease or Syndrome
Synonyms: Dermatostomatitis, erythema multiforme type; EM; Erythema multiforme bullosum; Erythema polymorphe, erythema multiforme type; Febrile mucocutaneous syndrome; Herpes iris, erythema multiforme type
SNOMED CT: EM - Erythema multiforme (36715001); Target lesion (36715001); Erythema multiforme (36715001)
 
Monarch Initiative: MONDO:0006545

Definition

A hypersensitivity reaction characterized by the sudden appearance of symmetrical cutaneous and mucocutaneous macular or papular lesions which evolve into lesions with bright red borders (target lesions). The lesions usually appear in the hands, feet, extremities, and face. Symptoms include fever, malaise, sore throat, cough, vomiting, diarrhea, arthralgia, and myalgia. Causes include infections (most commonly herpes simplex virus), drugs (e.g., sulfonamides, anticonvulsants, and antibiotics), malignancies, and collagen vascular disorders. [from NCI]

Professional guidelines

PubMed

Soares A, Sokumbi O
Medicina (Kaunas) 2021 Sep 1;57(9) doi: 10.3390/medicina57090921. PMID: 34577844Free PMC Article
Trayes KP, Love G, Studdiford JS
Am Fam Physician 2019 Jul 15;100(2):82-88. PMID: 31305041
Trayes KP, Savage K, Studdiford JS
Am Fam Physician 2018 Sep 1;98(5):283-291. PMID: 30216021

Recent clinical studies

Etiology

Grünwald P, Mockenhaupt M, Panzer R, Emmert S
J Dtsch Dermatol Ges 2020 Jun;18(6):547-553. Epub 2020 May 29 doi: 10.1111/ddg.14118. PMID: 32469468
Chapple ILC, Mealey BL, Van Dyke TE, Bartold PM, Dommisch H, Eickholz P, Geisinger ML, Genco RJ, Glogauer M, Goldstein M, Griffin TJ, Holmstrup P, Johnson GK, Kapila Y, Lang NP, Meyle J, Murakami S, Plemons J, Romito GA, Shapira L, Tatakis DN, Teughels W, Trombelli L, Walter C, Wimmer G, Xenoudi P, Yoshie H
J Periodontol 2018 Jun;89 Suppl 1:S74-S84. doi: 10.1002/JPER.17-0719. PMID: 29926944
Lerch M, Mainetti C, Terziroli Beretta-Piccoli B, Harr T
Clin Rev Allergy Immunol 2018 Feb;54(1):147-176. doi: 10.1007/s12016-017-8654-z. PMID: 29188475
Guarrera M
Adv Exp Med Biol 2017;996:61-70. doi: 10.1007/978-3-319-56017-5_6. PMID: 29124691
Singh M, Alavi A, Wong R, Akita S
Am J Clin Dermatol 2016 Jun;17(3):277-92. doi: 10.1007/s40257-016-0186-4. PMID: 27021652

Diagnosis

Soares A, Sokumbi O
Medicina (Kaunas) 2021 Sep 1;57(9) doi: 10.3390/medicina57090921. PMID: 34577844Free PMC Article
Rizo-Potau D, Marti-Marti I, Fustà-Novell X
Med Clin (Barc) 2021 May 21;156(10):533. Epub 2020 Sep 18 doi: 10.1016/j.medcli.2020.04.063. PMID: 32951886
Grünwald P, Mockenhaupt M, Panzer R, Emmert S
J Dtsch Dermatol Ges 2020 Jun;18(6):547-553. Epub 2020 May 29 doi: 10.1111/ddg.14118. PMID: 32469468
Trayes KP, Love G, Studdiford JS
Am Fam Physician 2019 Jul 15;100(2):82-88. PMID: 31305041
Samim F, Auluck A, Zed C, Williams PM
Dent Clin North Am 2013 Oct;57(4):583-96. doi: 10.1016/j.cden.2013.07.001. PMID: 24034067

Therapy

Stone GW, Christiansen EH, Ali ZA, Andreasen LN, Maehara A, Ahmad Y, Landmesser U, Holm NR
Lancet 2024 Mar 2;403(10429):824-837. Epub 2024 Feb 21 doi: 10.1016/S0140-6736(23)02454-6. PMID: 38401549
Soares A, Sokumbi O
Medicina (Kaunas) 2021 Sep 1;57(9) doi: 10.3390/medicina57090921. PMID: 34577844Free PMC Article
Khicher S, Weinberger JJ
Am J Ther 2020 Nov/Dec;27(6):e674-e675. doi: 10.1097/MJT.0000000000001038. PMID: 31356340
Singh M, Alavi A, Wong R, Akita S
Am J Clin Dermatol 2016 Jun;17(3):277-92. doi: 10.1007/s40257-016-0186-4. PMID: 27021652
Stoopler ET, Houston AM, Chmieliauskaite M, Sollecito TP
J Emerg Med 2015 Dec;49(6):e197-8. Epub 2015 Aug 15 doi: 10.1016/j.jemermed.2015.06.018. PMID: 26281815

Prognosis

Hasegawa A, Abe R
F1000Res 2020;9 Epub 2020 Jun 16 doi: 10.12688/f1000research.24748.1. PMID: 32595945Free PMC Article
Grünwald P, Mockenhaupt M, Panzer R, Emmert S
J Dtsch Dermatol Ges 2020 Jun;18(6):547-553. Epub 2020 May 29 doi: 10.1111/ddg.14118. PMID: 32469468
Patel S, John AM, Handler MZ, Schwartz RA
Am J Clin Dermatol 2020 Jun;21(3):393-399. doi: 10.1007/s40257-020-00505-3. PMID: 32002848
Canavan TN, Mathes EF, Frieden I, Shinkai K
J Am Acad Dermatol 2015 Feb;72(2):239-45. doi: 10.1016/j.jaad.2014.06.026. PMID: 25592340
Yong AA, Tey HL
Australas J Dermatol 2013 Nov;54(4):241-50. Epub 2012 Jul 3 doi: 10.1111/j.1440-0960.2012.00921.x. PMID: 22759072

Clinical prediction guides

Gambichler T, Boms S, Susok L, Dickel H, Finis C, Abu Rached N, Barras M, Stücker M, Kasakovski D
J Eur Acad Dermatol Venereol 2022 Feb;36(2):172-180. Epub 2021 Nov 2 doi: 10.1111/jdv.17744. PMID: 34661927Free PMC Article
Narita Y, Nagane M, Mishima K, Terui Y, Arakawa Y, Yonezawa H, Asai K, Fukuhara N, Sugiyama K, Shinojima N, Kitagawa J, Aoi A, Nishikawa R
Neuro Oncol 2021 Jan 30;23(1):122-133. doi: 10.1093/neuonc/noaa145. PMID: 32583848Free PMC Article
Hasegawa A, Abe R
F1000Res 2020;9 Epub 2020 Jun 16 doi: 10.12688/f1000research.24748.1. PMID: 32595945Free PMC Article
Grünwald P, Mockenhaupt M, Panzer R, Emmert S
J Dtsch Dermatol Ges 2020 Jun;18(6):547-553. Epub 2020 May 29 doi: 10.1111/ddg.14118. PMID: 32469468
Lerch M, Mainetti C, Terziroli Beretta-Piccoli B, Harr T
Clin Rev Allergy Immunol 2018 Feb;54(1):147-176. doi: 10.1007/s12016-017-8654-z. PMID: 29188475

Recent systematic reviews

Stone GW, Christiansen EH, Ali ZA, Andreasen LN, Maehara A, Ahmad Y, Landmesser U, Holm NR
Lancet 2024 Mar 2;403(10429):824-837. Epub 2024 Feb 21 doi: 10.1016/S0140-6736(23)02454-6. PMID: 38401549
Haseeb A, Elhusseiny AM, ElSheikh RH, Tahboub MA, Kwan JT, Saeed HN
Ocul Surf 2023 Apr;28:1-10. Epub 2022 Nov 14 doi: 10.1016/j.jtos.2022.11.007. PMID: 36396020
Nadelmann ER, Yeh JE, Chen ST
JAMA Oncol 2022 Jan 1;8(1):130-138. doi: 10.1001/jamaoncol.2021.4318. PMID: 34709352
Zuber M, Harikrishna, Vidhyashree, Chhabra M, Venkataraman R, Kumar S, Rashid M
J Basic Clin Physiol Pharmacol 2022 Sep 1;33(5):549-565. Epub 2021 Oct 27 doi: 10.1515/jbcpp-2021-0165. PMID: 34706401
Canavan TN, Mathes EF, Frieden I, Shinkai K
J Am Acad Dermatol 2015 Feb;72(2):239-45. doi: 10.1016/j.jaad.2014.06.026. PMID: 25592340

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