Diana Bukauskaitė¹

¹ Lithuanian University of Health Sciences, Academy of Medicine, Faculty of Medicine, Kaunas, Lithuania

Abstract

Background. EM is a hypersensitivity reaction that varies in the intensity of clinical signs between patients. Disease recognition and timely treatment remain a major challenge today due to the multifaceted etiology and wide range of treatment options.

Aim. To review the principles of etiology, clinical manifestation, diagnostics and treatment of erythema multiforme.

Methods. Literature sources were selected from PubMed and UpToDate scientific databases, using the keywords and their combinations: erythema multiforme, etiology, diagnostics, treatment.

Results. EM is a polyethiological syndrome, but as many as 90% of cases are associated with infectious origin. EM is characterized by up to 10% damage to the skin area. The typical feature of EM is a target-type rash, where the rash elements are round and have three color concentric zones. Mucosal lesions are seen in 25 – 60% patients with erythema multiforme. EM is usually diagnosed based on the patient’s medical history and physical examination, mild EM does not require treatment and resolves spontaneously but symptomatic treatment is needed.

Conclusions. A majority of EM cases are related to infections, mostly HSV infection, as well as medication use. The typical feature of EM is a target-type rash, where the rash elements are round and have three color concentric zones. EM is usually diagnosed on the basis of the patient’s medical history and physical examination, and in unclear cases laboratory tests and skin biopsy should be performed to eliminate other dermatoses.  Most cases do not require treatment and resolves spontaneously, although symptomatic treatment is significant.

Keywords: erythema, diagnstics, treatment.