Erythema multiforme exudative

Erythema multiforme exudative is the formation of polymorphic
rashes on the skin and mucous membranes. Erythema multiforme is one of
forms of erythema, which is characterized by acute and propensity
to relapse in the spring – autumn period.

Also, this term includes similar clinical
symptoms of the disease that develop as a result
allergic reactions or some infectious diseases. So
thus, erythema multiforme exudative is
two basic forms:

  • symptomatic that has a toxic-allergic
  • idiopathic which has infectious-allergic

With symptomatic or toxic-allergic form,
exudative erythema develops as an allergic reaction to
medications. Most often it is antibiotics, serum,
vaccines, sulfa drugs.


In idiopathic form, the disease has an infectious
allergic origin. So in most patients
there are chronic foci of infection in the body in the form of caries,
antritis, pyelonephritis, tonsillitis, otitis media, periodontal disease. Many
experts are also inclined to the infectious nature of this

The disease can be long lasting, counting
years and even decades. Erythema multiforme exudative
develops in young people and middle-aged people.


  • Development mechanism
  • Clinical picture
  • Diagnostics
  • Treatment
  • Treatment of folk remedies
  • Prognosis and prevention

Development mechanism

At the moment, modern medicine has not yet revealed the exact
causes of exudative erythema multiforme. Most
patients suffering from this disease are observed
concomitant foci of chronic infection and increased
sensitization to bacteria and viruses. Also in these patients
a decrease in T-cell immunity. For this reason
many researchers talk about the relationship of immunodeficiency
conditions and exudative erythema multiforme. In this way,
can be called the main factors that can provoke
exudative erythema:

  • reduction of the protective properties of the body;
  • the development of an immunodeficiency state;
  • chronic foci of infection in the body;
  • hypothermia;
  • viral infection;
  • toxic allergenic agents;
  • climacteric factors (sharp change in weather

Clinical picture

Symptoms of the disease depend on the form of exudative erythema.
For example, idiopathic or infectious – allergic erythema
has, as a rule, an acute onset. The disease begins by type
influenza infection. Patients feel weakness, chills, malaise
with headache, joint pain, cough, runny nose
and sore throat. After a day, rashes appear on the skin, and
a rash on the mucous membranes of the mouth, less often affects the mucous membranes of the genital
organs. After the appearance of symptoms on the skin, the general symptoms
disappear, and only in some cases temperature

The main symptoms of exudative erythema are characterized in
the appearance of red spots on the skin or papular spots
characters that are rapidly increasing in size. Staining stains
specific and uneven: in the center the spot has a bluish
shade, and on the edges of a bright red.

Sometimes watery bubbles appear in the center of the spots, which
may also have bloody contents.

Rash with exudative erythema usually develops on
the hands, on the skin of the feet, forearms and legs. In case of defeat
oral mucous membranes, the disease becomes more severe
for, as the rash appears on the lips, palate, upper tongue.
Rashes cause a lot of suffering to the patient, since patients with
erythema multiforme oral mucous membranes experience the strongest
pain syndrome. First, the edema appears on the mucous membranes, then
blisters and erosion. Erosion tends to merge, forming an extensive
wound surface. They are also able to ulcerate and bleed.
Erosion can become whitish and bloody crusts,
when removing which the wound begins to bleed. Disease
becomes very difficult, as sometimes erosion
extend to the entire oral mucosa. In this case, the patient is not
can neither eat, nor drink, nor talk, even open his mouth for him
is problematic. Usually skin rashes are stopped in
for 2-3 weeks, with the defeat of the mucous membranes of the mouth, the disease is not
It takes more than a month.

Symptomatic or toxic-allergic form of exudative
Erythema has the same symptoms as the idiopathic form. But
with this form, all patients are necessarily observed
lesions of the mucous membranes of the mouth. Remarkable is the fact that
rashes appear in the same places where they were observed at
previous exacerbations, but also new lesions are possible
skin. In this form of erythema except lesions of the mucous membranes
of the mouth, there are rashes and mucous membranes of the genital
organs. Also characteristic feature of this form is
lack of general ill health, and fever appears
simultaneously with a rash. This form of the disease is less dependent on
seasonal factor. In some cases, exudative multiforme
erythema is permanent due to recurring


The clinical dermatologist diagnoses the disease
and collected history. For accurate diagnosis is carried out
dermatoscopy, and from the surface of the affected skin and mucous membranes
take grease prints. To the characteristic symptoms of exudative
Erythema include the following phenomenon:

  • acute form of the disease;
  • recurrence of the disease;
  • mild general symptoms;
  • lack of acantholytic cells in microscopic
  • negative result for Nikolsky syndrome.

Exudative erythema must be differentiated with the following

  • erythema nodosum;
  • systemic lupus erythematosus;
  • syphilitic papules;
  • pemphigus.


Treatment of exudative erythema depends on its form and clinical
manifestations, that is, treatment is symptomatic. So,
for example, the treatment strategy for the toxic-allergic form consists
in quickly stopping the development of an allergic reaction, and
it means you need to take a series of quick actions to eliminate
toxic-allergic agent from the body. In this case
It is advisable to use enterosorbents and diuretics.
Any form of exudative erythema requires therapy directed
on the desensitization of the body. For this, patients are prescribed
antihistamine drugs.


The use of antibiotics is justified only if
there was the accession of a secondary bacteriological infection

Local treatment includes the following actions:

  • affected areas are treated with antiseptic
    drugs: furatsilinom or chlorhexidine;
  • use of antibacterial ointments with proteolytic
  • use of corticosteroids;
  • washing wounds with a decoction of chamomile, as well as a solution of the drug
  • grease wounds with sea buckthorn oil;
  • treatment of folk remedies.

Treatment of folk remedies

Folk remedies can be very effective in treating
exudative erythema multiforme. However, if you decide
resort to an alternative method of treatment, then compulsory
procedure, you should consult a dermatologist and
get his approval. Even treatment with folk remedies is necessary
exercise under the guidance of a professional.

Very effectively eliminates the symptoms of exudative erythema decoction
arnica. Make a decoction as follows: take a thermos,
put 2 tablespoons of dried herbs into it, or 5 tablespoons
fresh, pour two cups of boiling water, close the thermos and
insist day. Also arnica can be prepared ointment. For this
take dry roots of arnica, pound to a powdery mass.
Mix 100 grams of powder with exactly the same amount of pork.
fat and leave on fire for three hours until the medicinal properties of the herb are
go to fat. Then the ointment is cooled and applied to the affected

Prognosis and prevention

The prognosis is favorable. However, there are serious
conditions that may be life-threatening.
This is Lyell syndrome and Stevens-Johnson syndrome.

Prevention of exudative erythema multiforme consists in
timely relief of foci of infection in the body, except
from the life of a patient with toxic-allergic agents.

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