What is erythema multiforme? How can I be completely better? I hope professionals can talk about it!

Erythema multiforme is an acute self-limiting inflammatory skin disease, often accompanied by mucosal damage. Rash is polymorphic, and the typical damage is target organ or iris damage. It can be caused by many reasons, such as infected bacteria, viruses (especially herpes simplex virus), enzyme bacteria and protozoa, and also by some drugs, such as sulfonamides, Bartonella, salicylates and biological products, which are related to human colds.

Erythema multiforme is an acute inflammatory skin disease, with target erythema or iris erythema as typical damage. Often accompanied by mucosal injury, easy to relapse. The etiology of this disease is complex, and drugs, chronic infection focus, food and physical factors can all cause this disease. Some diseases, such as rheumatic fever and connective tissue diseases, can also appear erythema multiforme. Clinically, the unknown cause is called idiopathic erythema multiforme, and the definite cause is called symptomatic erythema multiforme.

The disease is self-limited, but it is easy to recur. The etiology of erythema multiforme has not been fully clarified so far, but it is generally considered to be a skin disease caused by allergic reaction. In recent years, the relationship between this disease and herpes simplex virus has attracted considerable attention. It has been pointed out that more than 30% patients with erythema multiforme are caused by herpes virus, which has been confirmed by experiments, that is, intradermal injection of herpes simplex virus antigen can cause disease. In addition, some cases are often drug eruptions caused by sulfonamides, antipyretic and analgesic drugs, sedatives and hypnotics, antibiotics, etc. The incidence of some patients is related to chronic infections, such as tonsillitis, otitis media, paranasal sinusitis and chronic adnexitis. Some are one of the clinical symptoms of diseases in vivo, such as rheumatic fever, typhoid fever, wave fever, infectious mononucleosis, malignant granuloma and various malignant tumors, which may be accompanied by erythema multiforme; Some patients are caused by eating fish, eggs and other daily foods. The causes of quite a few diseases are still difficult to find.

Erythema multiforme often occurs in spring and autumn, and the onset is often urgent. Precursor symptoms include low fever, headache, weakness of limbs, joint and muscle pain. Some patients may have herpes simplex or upper respiratory tract infection at the same time or before onset. Rash often occurs on the face, neck and distal limbs, and mucous membranes such as mouth and eyes can also be involved. Lesions are polymorphic, such as erythema, maculopapules, blisters, blisters and purple spots with wheal, but maculopapules and erythema are the most common. The typical damage color is inner ultraviolet red, and blisters can appear in the center. The appearance is very strange. Every rash has a clear boundary, like a target. This is the so-called iris-like lesion. Seeing such a rash is helpful for diagnosis. Itching or mild pain and burning sensation in the affected area. Generally, there are no obvious systemic symptoms at the time of onset, and the course of disease is self-limited. Skin lesions are expected to subside after about 2-4 weeks, but they often recur.

In addition, two special types can be seen clinically, namely erythema multiforme and Stephens-Johnson syndrome.

Pleomorphic cold erythema: this type is mostly young women, which occurs in the cold season every year. It usually happens on the back of hands, feet and toes. The rash is dark red papule or purplish red blood blister, about the size of rice grain to mung bean, with occasional iris-like damage. Patients sometimes have mild swelling, cold hands and feet and frostbite-like changes. Itching consciously, especially when it's warm. One by one, there are dark red spots after healing.

Stephens-Johnson syndrome, also called malignant bullous erythema multiforme. This type can be regarded as severe erythema multiforme. The common cause is drugs. This type is mostly children and adolescents, with sudden onset and serious illness. Rash can attack the whole body, especially the face, hands and feet. Mucosal involvement of the mouth, eyes, nose, urethra and genitals is not uncommon. Stomatitis is often the early symptom of the syndrome, and almost all patients can find mucosal damage in this part. Rash is characterized by erythema, purple spots, blisters, bullae, blood blisters, erosion and scabbing. Lesions often expand rapidly and can merge with each other, but the acantholysis phenomenon of epidermis, that is, Nissl's sign, is negative. Patients are often accompanied by headache, fatigue, high fever and other systemic symptoms, and in severe cases, toxic failure may occur. Sometimes it can be complicated with bacterial infection and die of pneumonia or septicemia. The course of the syndrome is long, and it will take about 3 ~ 6 weeks to recover.

It is not difficult to diagnose the disease according to its polymorphic rash and prone parts. But it should be differentiated from chilblain, drug eruption (erythema multiforme) and herpetic dermatitis.

Modern medicine mainly uses antiallergic treatment for this disease. Mild cases were given oral antihistamines, vitamin C and calcium. Severe cases are treated with corticosteroids. At the same time, we should pay attention to controlling infection.

Cold erythema multiforme is caused by "cold" and "blood stasis", which causes blood vessels to contract, local blood flow velocity to slow down, abnormal cryoglobulin, fibrinogen and condensate in blood circulation to increase, and the aggregation of itself and red blood cells to increase, making blood thicken and sticky, coagulating and precipitating in blood vessels, aggravating blood flow obstacles and damaging blood vessel walls, thus causing pathological changes. Therefore, the treatment of this kind of erythema multiforme should focus on promoting blood circulation and removing blood stasis.

This disease is called "goose sore", "cold sore" and "pig eye sore". Traditional Chinese medicine believes that pathogenic wind-cold stagnates in the skin, leading to exogenous pathogens, damp-heat blocking collaterals, stagnation of qi and blood, and stagnation of heat for a long time, overflowing the skin; Or there is dampness inside, which is caused by wind and heat, and wind and heat evil beats on the muscle surface; Or because of temperament intolerance, heat poison internal strength; Or a combination of heat toxicity and damp heat.

If it is caused by hot and humid weather, it is a red and itchy pimple that grows on the legs or hands. Calamine mixture should be used for external use, which can often be cured.

Calamine lotion is a commonly used topical drug in dermatology. Because it is a suspension made of water-insoluble calamine powder and water containing a small amount of glycerol, zinc oxide and phenol, it will feel cool and relieve itching locally because of the evaporation of water after being coated on the skin.

Calamine is also called heteropolar ore. The calamine and zinc oxide contained in the lotion can converge, protect and absorb a small amount of exudate, and also have a weak antiseptic effect. In addition, it contains no hormones and has good anti-inflammatory, heat dissipation, moisture absorption, itching relief, convergence and protection effects. It can be used for acute dermatitis such as papule, subacute dermatitis, eczema, miliaria, urticaria, etc. with flushing, swelling, burning, itching and no exudation.