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Erythema Multiforme an acute, self-limiting, inflammatory skin eruption. Most common cause is Herpes Simplex Occurs in response to medications, infections Medications include: Barbiturates Penicillins Phenytoin Sulfonamides Infections include: Herpes simplex Mycoplasma Erythema Multiforme Data EG 43 y/o F Begin as sharply marginated, erythematous ill-defined (brief description of pathology) erythematous macules, which become asymptomatic patches raised, edematous papules over 24 to (epidemiology, incidence, etc.) (upper extremities, with 48 hours tingling sensation, “target” or “iris” lesion with 3 zones – numbness of the hands) central dusky purpura; an elevated, into multiple edematous, pale ring; and surrounding erythematous to skinmacular erythema colored plaques and nodules 1.5x 3.5 to 2.0 x Age of Predilection 4.0 cm (malar area, helix Young adults of ears, upper extremities, thighs) Site of predilection (+) leonine facies dorsal hands, dorsal feet, extensor limbs, elbows and knees, and (-) madarosis Lesion Patient’s palms and soles There are two types of EM: EM minor and EM major. EM minor comprises nearly 70% of the cases. Most cases of EM minor resolve in one to three weeks EM major might take three to six weeks to resolve. Recurrences are more commonly seen in EM minor, but are rare in EM major. Traditionally, Stevens- Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) were included in the same spectrum as EM. EM MINOR Most patients with EM minor present with new- onset mucocutaneous lesions which are usually symmetrical and rapidly progressing in nature. These lesions may be pruritic or may be associated with a burning sensation. EM MAJOR EM major is usually preceded by prodromal symptoms such as fatigue, fever, headaches, and myalgias. These symptoms can appear up to two weeks prior to the mucocutaneous manifestations. Oral mucosal involvement may lead to difficulty in drinking and eating. Ocular involvement may lead to complaints of redness, discharge and ocular pain. Treatment Prevention is cornerstone of treatment if HSV can be demonstrated as the trigger. Antiherpetic antibiotic