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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
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
Sokumbi O, Wetter DA
Int J Dermatol 2012 Aug;51(8):889-902. doi: 10.1111/j.1365-4632.2011.05348.x. PMID: 22788803
Shah KN, Honig PJ, Yan AC
Pediatrics 2007 May;119(5):e1177-83. doi: 10.1542/peds.2006-1553. PMID: 17470565

Diagnosis

Soares A, Sokumbi O
Medicina (Kaunas) 2021 Sep 1;57(9) doi: 10.3390/medicina57090921. PMID: 34577844Free 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
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
Sokumbi O, Wetter DA
Int J Dermatol 2012 Aug;51(8):889-902. doi: 10.1111/j.1365-4632.2011.05348.x. PMID: 22788803

Therapy

Soares A, Sokumbi O
Medicina (Kaunas) 2021 Sep 1;57(9) doi: 10.3390/medicina57090921. PMID: 34577844Free PMC Article
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
Rodríguez-Pazos L, Gómez-Bernal S, Rodríguez-Granados MT, Toribio J
Actas Dermosifiliogr 2013 Oct;104(8):645-53. Epub 2013 Aug 17 doi: 10.1016/j.adengl.2012.01.024. PMID: 23962583
Sokumbi O, Wetter DA
Int J Dermatol 2012 Aug;51(8):889-902. doi: 10.1111/j.1365-4632.2011.05348.x. PMID: 22788803
Lamoreux MR, Sternbach MR, Hsu WT
Am Fam Physician 2006 Dec 1;74(11):1883-8. PMID: 17168345

Prognosis

Bennardo L, Nisticò SP, Dastoli S, Provenzano E, Napolitano M, Silvestri M, Passante M, Patruno C
Medicina (Kaunas) 2021 Aug 16;57(8) doi: 10.3390/medicina57080828. PMID: 34441034Free 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
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

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
McMahon DE, Amerson E, Rosenbach M, Lipoff JB, Moustafa D, Tyagi A, Desai SR, French LE, Lim HW, Thiers BH, Hruza GJ, Blumenthal KG, Fox LP, Freeman EE
J Am Acad Dermatol 2021 Jul;85(1):46-55. Epub 2021 Apr 7 doi: 10.1016/j.jaad.2021.03.092. PMID: 33838206Free 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

Seirafianpour F, Pourriyahi H, Gholizadeh Mesgarha M, Pour Mohammad A, Shaka Z, Goodarzi A
Dermatol Ther 2022 Jun;35(6):e15461. Epub 2022 Apr 11 doi: 10.1111/dth.15461. PMID: 35316551Free PMC Article
Nadelmann ER, Yeh JE, Chen ST
JAMA Oncol 2022 Jan 1;8(1):130-138. doi: 10.1001/jamaoncol.2021.4318. PMID: 34709352
Erbaş GS, Botsali A, Erden N, Arı C, Taşkın B, Alper S, Vural S
Int J Dermatol 2022 Jan;61(1):20-32. Epub 2021 Sep 22 doi: 10.1111/ijd.15889. PMID: 34549816Free PMC Article
Zoghaib S, Kechichian E, Souaid K, Soutou B, Helou J, Tomb R
J Am Acad Dermatol 2019 Sep;81(3):813-822. Epub 2019 Jul 19 doi: 10.1016/j.jaad.2019.02.057. PMID: 31331726
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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