Erythema multiforme is a reddening, swelling, and sometimes blistering of the skin. A milder form, called erythema multiforme minor, usually doesn’t cause complications and clears up on its own.
The mild form usually affects children and young adults, lasts from 2 to 4 weeks, and can recur during the first few years. The more severe form, called Stevens Johnson syndrome or erythema multiforme major, can cause serious symptoms that need prompt treatment and maybe hospitalization.
The cause is unknown in half the cases. Most of these skin irritations result from infections, allergic reactions to drugs such as penicillin or vaccines, physical conditions such as pregnancy and other hormone changes, and illnesses such as cancer.
Skin in the minor form has round red bumps and blisters on the face, lips, arms, and legs on both sides of the body. These bumps can look like red or pink targets; they can become large blisters. Fever and muscle and joint aches may be present.
In the serious form, people have high fever, large blisters, severe itching, and ulcers on membranes of the mouth, nose, eyes, genital area, arms, and skin. Without complications, symptoms go away in 4 weeks, but mouth sores can last for months. Untreated eye involvement can lead to blindness.
Blood tests may be done to check for an infection. A skin biopsy may also be done to rule out another medical condition. In a biopsy, a small sample of skin with the rash will be removed and studied with a microscope.
Treatment focuses on controlling the cause and symptoms. For a drug reaction, the drug needs to be stopped. If a bacterial infection is the cause, antibiotics are given.
Symptoms are relieved by using moist compresses (for itching), soothing lukewarm or cool baths, drugs such as steroid (prednisone) creams (for itching and swelling), mouthwashes and rinses (for mouth blisters), and eyewash and other topical medicine (for a rash near the eyes). Eye involvement may mean a visit to an eye specialist.
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