Erythema multiforme exudative: symptoms and treatment

Multiforme exudative erythema is an acute disease that affects the skin and mucous membranes in the human body. It is characterized by the appearance of polymorphic eruptions, as well as a recurrent course. Most often, the disease affects people of middle and young age, but it is also diagnosed in children. Erythema multiforme is a fairly common disease that most often manifests itself during the off-season.

This term is used by specialists to denote similar (clinically manifested) rashes that begin to progress due to certain infectious diseases or allergic reactions. Proceeding from this, two forms of an ailment are distinguished:

  • infectious-allergic
  • toxic-allergic exudative erythema.


To date, scientists have not yet established exactly what causes provoke the progression of the infectious-allergic form of the disease. But many tend to the fact that the cause of the development of the disease can be focal infection, which is already present in the human body. This factor occurs in approximately 70% of all patients who have been diagnosed with multiforme exudative erythema. They have an increased sensitization to infectious agents (pathogenic microorganisms). At a time when the recurrence of pathology is developing, immunity is significantly reduced.

Based on this, scientists admit that the main cause of the progression of the infectious-allergic form is the immunodeficiency state that developed because of:

  1. hypothermia
  2. chronic infection;
  3. infection with a viral infection
  4. heliomagnetic effects.

The main reason for the development of a toxic-allergic form of pathology is the intake of medications from various groups. Most often, the body reacts to taking drugs from the tetracycline series, barbiturates.


  • toxic-allergic. For her characteristic pronounced hyperemia of the foci is characteristic. They also have the property of merging. More often «mucous» (oral cavity, mucous of genital organs and other) «attack». The epidermal component is a blister;
  • an infectious-allergic form. In this case, small pathological elements appear on the skin that do not tend to merge. Most often they are localized to the skin of the lower extremities. Mucous cavity of the mouth, genital organs is rarely affected. This form of ailment occurs most often, so it is not difficult to diagnose it. Scientists have identified a large number of infectious agents that can trigger the progression of pathology. As a rule, these are microorganisms that form pathological foci of chronic persistence in the human body, which have the property of periodically exacerbating;
  • The most severe form of exudative erythema is Stevens-Johnson syndrome . Together with the defeat of the skin and the oral mucosa, the eyes, nose and genital organs are affected. If you do not begin to conduct adequate treatment in a timely manner, then even a lethal outcome is possible.


Symptoms of pathology vary depending on which particular form of the disease affects a person. The symptoms are the same in both adults and children. It should be noted that it is in children that the multiform exudative erythema is more severe. Therefore, it is important at the first sign of disease progression to immediately take the child to a medical facility.

Infectious-allergic exudative erythema


  1. headache;
  2. malaise
  3. sore throat, joints
  4. Rashes are formed on the skin. They are also noted on the mucous membrane of the mouth, on the lip of the lips and on the genitals. It should be noted that the rash can sometimes be located only in one place, for example, only in the mouth or only on the genitals
  5. symptoms of intoxication occur 2-5 days after the onset of rashes, but the temperature can last up to 3 weeks;

On the skin or on the oral mucosa there are edematous limited spots or flat papules. They have a pinkish-reddish color. Education data is increasing very quickly. The maximum size is 3 cm. The central part of the eruptions is slightly sagging and has a cyanotic shade. Also in the center can be formed pathological vesicles, inside of which there is exudate. The patient notes that the rashes itch. But more often there is a burning sensation.

Excessive erythema on the oral mucosa

The clinic of exudative erythema on the oral mucosa is more monotonous. But this form of pathology proceeds particularly hard, since the subjective symptoms are very clearly expressed. Favorite location of the rashes — the sky, cheeks, the mouth of the mouth, lips.

It is worth noting that the disease begins acutely and suddenly. First, edematous and diffuse erythema forms on the mucous membrane of the oral cavity, but after a few days, bubbles form on it. A few days later they are opened and erosive areas are formed. They can be so large that they cover the entire mucosa of the oral cavity, as well as the lips. Erosive areas are often covered with a specific yellowish-gray coating. It is easy to separate it, but then there is parenchymal bleeding.

Thick bloody crusts often form on the lips, which do not allow full opening of the mouth. It should be noted that in some people erosion can cover the entire oral cavity, while in others, on the contrary, only single erythematous-bullous eruptions appear.

With extensive damage to the oral mucosa, symptoms are as follows:

  • Severe soreness
  • Exudate is separated from the surface of erosions in large quantities
  • increased salivation;
  • you can not open your mouth completely
  • speech is difficult
  • it is impossible to take even liquid food.

Toxico-allergic form

With this form, a rash appears, which is visually very similar to the eruptions in case of an infectious-allergic form. Foci are both fixed and common. If there are common eruptions, the mucous membrane of the mouth is most often affected.

Fixed rashes, as a rule, appear in the very places where they occurred before, but this does not mean that they can not arise on other sites. Most often, the oral cavity is affected, since it is in this area that the sensitivity to drugs is quite high. It is worth noting that sometimes bubbles can occur on the unchanged skin or mucous membrane.

This form of pathology is not peculiar to seasonality. She is not preceded by any symptoms. Rarely when the body temperature may slightly increase.


The clinic of multiforme exudative erythema is so typical that sometimes the need for additional methods of investigation is eliminated. But sometimes doctors resort to biopsy formations, as well as to smears-prints. This allows them to exclude some other ailments.

Differential diagnosis is carried out with such pathologies:

  1. Flat lichen
  2. pemphigus;
  3. Dühring’s disease
  4. pemphigoid
  5. secondary syphilis.


Treatment of multiforme exudative erythema in children and adults is carried out approximately in the same way:

  • the first thing to do is completely eliminate the effect on the body of drug and food allergens
  • if a person is allergic to food, he is shown to take enterosorbents;
  • Aniline solutions are used in the presence of skin rashes
  • if an infection has joined the erythema, broad-spectrum antibiotics are also added to the main course of treatment
  • if the disease is very severe, then the course of treatment is supplemented with corticosteroid ointments or injections
  • ointments and aerosols with an analgesic effect are used for local treatment
  • Vitaminotherapy;
  • To quickly eliminate the rash in the mouth, you should regularly rinse it with Rotokan solution, boric acid solution or solution of potassium permanganate. This method of treatment is quite effective.

Treatment of pathology is carried out under stationary conditions under the constant supervision of specialists.

In some cases, as an auxiliary therapy may prescribe folk remedies. But they can not be used independently, in any case, as it is possible to aggravate the course of the disease. Treatment with traditional medicine is also prescribed only by the attending physician.

Treatment with folk remedies:

  1. broth from arnica (barantsa)
  2. arnica ointment
  3. chamomile broth.

Prevention and Forecast

The prognosis for exudative erythema multiforme is usually favorable (provided timely and adequate treatment is provided). Prevention is the timely treatment of foci of infection, as well as the exclusion of drugs that can trigger allergies (hormones, antibiotics, etc.).