Dr. M.J. Bazos, MD Patient Handout


About Your Diagnosis

Erythema Multiforme is a relatively common disorder that affects the skin and sometimes the internal organs. The extent of involvement of the internal organs varies greatly, but widespread or severe involvement is rare. There are many causes of erythema multiforme. These include viral and bacterial infections, certain chronic diseases, pregnancy, cancer, and others. In more than half of all cases a cause cannot be found. The diagnosis can usually be made on examination by a doctor, but a biopsy is frequently done to confirm the diagnosis. Most cases of erythema multiforme resolve with treatment, but severe cases may require hospitalization.

Living With Your Diagnosis
In the minor form of erythema multiforme, there are round, red bumps and blisters on both sides of the body that occur on the arms, legs, face, and lips. These bumps can take on the appearance of red or pink targets, or they can become large blisters. The rash itches a lot and may develop into hives. It usually affects children and young adults and lasts from 2 to 4 weeks. Fever and muscle and joint aches may be present. It can recur during the first few years. Erythema multiforme major, also called Stevens- Johnson syndrome, is a more serious illness with high fever, large blisters, and ulcers on membranes of the mouth, nose, eyes, genital area, arms, and skin. There may be severe itching and occasionally lung involvement. If there are no complications, symptoms resolve in 4 weeks, but mouth sores can persist for months. Untreated eye involvement can lead to blindness. Severe cases require hospitalization.

Mild cases of erythema multiforme may not require any treatment. Prednisone may be used if necessary. If your doctor suspects a medication you are taking may have caused your problem, the medication will be stopped. Antibiotics are used when a secondary infection occurs. Any medical illness causing erythema multiforme should be treated as appropriate. Steroid creams applied to skin may be prescribed. Erythema multiforme associated with herpes simplex virus can recur, and preventive medications are frequently used. Itching can be controlled with antihistamines such as Benadryl. Mouth pain is frequently treated with lidocaine rinses. Eye involvement may require a consult with an eye specialist.

The DOs
• Apply cool wet Burow’s compresses to blisters, or just a cool wet cloth can be used.
• Call your doctor immediately if any vision changes occur.
• Take acetaminophen for pain unless otherwise directed by your doctor.

The DON’Ts
• Don’t apply skin creams or ointments to broken or bleeding skin.
• Don’t take hot baths or hot showers. These can make the skin itch more. Cool or lukewarm baths may help.
• Avoid strenuous or vigorous activities if ill with fever, headaches, or malaise.

When to Call Your Doctor
• Call immediately if any decreased vision or eye pain develops during treatment.
• If persistent vomiting or diarrhea occur.
• If new symptoms occur during treatment, or if symptoms worsen significantly.