- This is a rash that appears suddenly. It usually is symmetrical (i.e., if it is on one arm, it is also on the other).
- It usually occurs between 10 and 30 years of age.
- It can be divided into two types: (1) Erythema multiforme minus (Hebra's disease); and (2) Stevens-Johnson syndrome, a very severe form.
- Stevens-Johnson syndrome can be life-threatening. It generally involves prominent blistering of the mouth and eyes.
- Fever, chills, lack of energy, muscle pain
- Skin rash on the arms, legs, palms, soles, mouth/lips
- It has multiple morphologic stages (multiple types of appearances):
- Red spots
- Red, raised, large lesions
- Red, raised, small lesions
- Deep red appearance
- Targetlike (red outside with clear inside)
- Erythema multiforme minus:
- Skin rashes over the face, dorsum of hands and feet, palms and soles. It may spread to trunk.
- Burning and itching.
- Stevens-Johnson syndrome:
- Fever, lack of energy, muscle pain, headache, and Diarrhea followed by skin eruption
- Prominent blistering
in mouth; and eye involvement (corneal ulcers or uveitis may occur)
- Denudation of skin
- It can be life threatening.
- Herpes simplex, Epstein-Barr virus, Mumps, Group A streptococci, Hepatitis B
- Mycoplasma pneumoniae (''walking pneumonia"), brucellosis, Diphtheria, etc.
- Protozoan and fungal
- Medications such as Dilantin, sulfa antibiotics, and anti-inflammatories
- Vaccines -- Tetanus, BCG, Diphtheria
- Certain diseases (e.g., sarcoidosis, collagen vascular diseases)
- Malignancy, such as Leukemia and lymphoma
- Radiation therapy
- Erythema multiforme minus --
- Oral antihistamines
- Moist compresses
- Stevens-Johnson syndrome -- treat in a burn unit
- Intravenous fluid and nutritional support
- Ophthalmologic consultation
- Topical anesthetics
- Saline or Burow's solution compresses
- Antibiotics for secondary bacterial infection
- Paraffin gauze or hydrogel dressing to denuded areas
- Corticosteroid treatment is often tried, but there is no clear evidence of effectiveness.
- For mouth lesions -- 1% diphenhydramine elixir mixed with Kaopectate or 1% dyclonine
- Seek immediate emergency treatment for your child. This condition, especially the Stevens-Johnson syndrome, can be life threatening.
- Drug reactions
- Rocky Mountain spotted fever
- Secondary syphilis
- Toxic shock syndrome