What is Erythema Multiforme/Steven Johnson Syndrome?
The meaning of the word “Erythema” is redness and “Multi” means many and “Forme” shapes. This is the hypersensitivity reaction of the skin, which is usually due to an infection like herpes simplex virus (HSV). It is presented mainly as a skin lesion; mucous membranes may also be involved. If it’s acute and self-limiting, it resolves without complications.
Alternate names:
Lyell’s syndrome; Erythema multiforme minor; Erythema multiforme major; Dermatostomatitis; Herpes iris.
Who is more prone to get affected by Erythema Multiforme/Steven Johnson Syndrome?
Erythema multiforme affects people of 20-40 years; it can affect infants and young children. Males and female are equally affected.
What are the causes of Erythema Multiforme/Steven Johnson Syndrome?
• Damaged immune system
• Mycoplasma pneumonia
• Herpes simplex
• Infection
• Fungal infection
• Medications
• Nonsteroidal anti-inflammatory drugs
What are the signs and symptoms of Erythema Multiforme/Steven Johnson Syndrome?
• Fever
• Itching of the skin
• General ill feeling
• Joints pain
• Multiple skin lesions which appear quickly and may return and spread
• Lesions appear as nodules, papule, macules or hives
• Mouth sores
• Bloodshot eyes
• Eyes pain
• Vision problem
• Dry eyes
• Eye burning, itching, and discharge
What investigations are advised in cases of Erythema Multiforme/Steven Johnson Syndrome?
• Complete case history
• Physical examination
• Skin lesion biopsy
• Skin examination under a microscope
• Nikolshy’s sign
What treatment is advised for Erythema Multiforme/Steven Johnson Syndrome?
• Antihistamines/ topical corticosteroids
• Antiseptic
• Antiviral medicines
• Antipyretics
• Tropical anesthesia
• Antibiotics
• Severe cases can be treated in an intensive care unit
• See ophthalmologist
• Good hygiene level
What is the prognosis of Erythema Multiforme/Steven Johnson Syndrome?
The prognosis of mild erythema multiform is good as it gets better in 2-6 weeks, but the problem may return whereas it’s hard to treat severe forms.
What are the complications of Erythema Multiforme/Steven Johnson Syndrome?
• Sepsis
• Permanent skin damage and scarring
• Cellulitis
• Shock
• Myocarditis
• Pneumonitis
• Nephritis
• Hepatitis
• Blood poisoning
• Permanent eye damage
What is the differential Diagnosis of Erythema Multiforme/Steven Johnson Syndrome?
• Autoimmune bullous disease
• Drug eruption
• Figurate erythema
• Lupus erythematosus
• Pityriasis rosea
• Polymorphic light eruption
• Urticaria
• Urticarial vasculitis
• Vasculitis
• Viral exanthema
• Other hypersensitivity reaction
• Behcet’s disease
• Drug reaction
What is the diet and management of Erythema Multiforme/Steven Johnson Syndrome?
• Keep proper hygiene level.
• Withdrawal of drugs
• Antiviral therapy is administered if a person has a history of HSV.
• A person is asked to take a well nutritious diet
• Drink plenty of fluids
• Quit alcohol and smoking
What are the commonly indicated Homeopathic remedies for Erythema Multiforme/Steven Johnson Syndrome?
-Arsenicum album
-Apis mellifica
-Rhus toxicodendron
-Sepia officinalis
-Sulphur
