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Erythema multiforme - Treatment

Alternative Names

Lyell's syndrome; Stevens-Johnson syndrome; Toxic epidermal necrolysis

Treatment:

Treatment goals include:

  • Controlling the illness that is causing the condition
  • Preventing infection
  • Treating the symptoms

Stop taking any suspected medications, with your doctor's approval.

Treatment of mild symptoms may include:

  • Medications such as antihistamines to control itching
  • Moist compresses applied to the skin
  • Over-the-counter medications (such as acetaminophen) to reduce fever and discomfort
  • Topical anesthetics (especially for mouth lesions) to ease discomfort that interferes with eating and drinking

Treatment of severe symptoms may include:

  • Antibiotics to control any skin infections
  • Corticosteroids to control inflammation
  • Hospitalization and treatment in an intensive care or burn care unit for severe cases, Stevens-Johnson syndrome, and toxic epidermal necrolysis
  • Intravenous immunoglobulins (IVIG) to stop the disease process

Practicing good hygiene and staying away from other people may help prevent secondary infections.

Skin grafting may be helpful in cases in which large areas of the body are affected.

In cases that are caused by the herpes virus, daily antiviral medications may be prescribed to prevent erythema multiforme from returning.

Expectations (prognosis):

Mild forms of erythema multiforme usually get better in 2 - 6 weeks, but they may return. More severe forms may be difficult to treat. Stevens-Johnson syndrome and toxic epidermal necrolysis have high death rates.

Complications:

  • Body-wide infection, sepsis
  • Loss of body fluids, shock
  • Occasionally, lesions on internal organs causing:
    • Heart inflammation (myocarditis)
    • Lung inflammation (pneumonitis)
    • Kidney inflammation (nephritis)
    • Liver inflammation (hepatitis)
  • Permanent skin damage and scarring
  • Skin infection (cellulitis)

Calling your health care provider:

Go to the emergency room or call the local emergency number (such as 911) if you have symptoms of erythema multiforme. If a large area of the body is involved, it is an emergency situation.

  • Reviewed last on: 10/3/2008
  • Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Lamoreux MR, Sternbach MR, Hsu WT. Erythema Multiforme. Am Fam Physician. 2006;74:1883-1888.

Erythema multiforme. In: Ferri FF. Ferri's Clinical Advisor. 1st ed. Philadelphia, Pa: Mosby Elsevier; 2009.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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