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Recurrent, superficial ulcers, with necrotic centre + red margin, involving movable mucosa of inner surface of lips, cheeks, tongue & soft palate Differences from viral ulcer 1. A macule is a change in surface color, without elevation or depression and, therefore, nonpalpable, well or ill-defined, variously sized, but generally considered less than either 5or 10 mm in diameter at the widest point. A plaque has been described as a broad papule, or confluence of papules equal to or greater than 1 cm. A papule is a circumscribed, solid elevation of skin with no visible fluid, varying in size from a pinhead to less than either 5 or 10 mm in diameter at the widest point.
A pustule is a small elevation of the skin containing cloudy or purulent material usually consisting of necrotic inflammatory cells.
Erythema multiforme is a common dermatological condition of idiopathic origin, potentially mediated by the accumulation of immune complex in the microvasculature surface of the skin and mucosa. Of the two types, EM minor is the less serious and accounts for 80% of Erythema multiforme cases. The Pathophysiology of Erythema multiforme is not yet fully implicated but it appears that there is a taking part of the cell-mediated hypersensitivity reaction by the immune system that can be elicited by variety of stimuli, specifically bacteria, viruses and chemicals. As revealed in a current global future analysis, the most important cause of Erythema multiforme is Herpes simplex virus, but bacterial, parasitic and fungal infections are also correlated.

The treatment starts with identifying the activating factor and removing it, however, this is not all the time achievable.
Erythema multiforme minor is typically without a clinical symptom therefore requires no treatment, as the lesions are self-limiting and will disappear within a month.
Disclaimer :All the Pictures on this Website are the properties of their respective owners and may not be copied or used to any other purposes without their written permission. Bi-weekly submucosal intra-lesional injections of Dexamethasone 4 mg + Hyaluronidase 1500 IU for 6- 8 wks 2. It is a severe, self-limiting inflammatory skin condition under type IV hypersensitivity reaction triggered by the exposure to certain medications, contagion and other factors. Together with the erythematous eruption, there are a few significant hemorrhagic blisters present.
In the case of Stevens-Johnson syndrome and toxic epidermal necrolysis, it looks to play a smaller role.
Give analgesics as needed, skin care; topical steroids, and soothing mouthwash and gargles. If the cause is infection, it must then be properly treated following the performance of diagnostic tests.

Aggressive observation and fluids and electrolytes replacement are of dominant significance. Excision of lesions & reconstruction with: buccal fat pad, naso-labial flap, lingual flap, palatal muco-periosteal flap, radial forearm flap 4.
Slight burning or mild itch may be existing but becomes most intense over the back of the hands and feet. For Erythema Multiforme minor and major, the principal risk factor is history of herpes infection or recurrent case of herpes. Classically, the rash appears as bull’s eye shaped circles on the palms arranged symmetrically and lasts for 7 to 14 days and then resolves leaving a remaining brown colored discoloration.

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