Exudative multiform erythema

Excessive erythema multiforme( Stevens-Jones syndrome) is an acute disease of the skin and mucous membranes of the oral cavity, which is characterized by papular, bladder and spotted rashes. In most cases, it occurs in children and in middle-aged people( more often male).Exudative erythema multiforme develops after infection of the upper respiratory tract;As an allergic reaction to certain types of infections, medicines and autotoxic substances. Cases of development of this disease after poisoning with gasoline, as well as due to developed intoxication due to snake bites were recorded.

A distinctive feature of exudative erythema multiforme is the erythematous papular skin formations, increasing towards the periphery, with vesicles in the center. These skin rashes can spread to a fairly large surface of the body( including the feet and palms), but the scalp is not affected. In the order of 15% of patients, only the mucous membrane of the mouth is affected. In its clinical manifestations, the exudative erythema multiforme of the oral mucosa is more monomorphic than on the skin, but it is much heavier in subjective sensations and in its flow. This process can be both localized and common, capturing almost the entire oral mucosa

Symptoms of

In most cases, the appearance of skin rashes is preceded by general malaise and fever( body temperature rises to 38-39 * C), headaches arise , andAlso joint and muscle pain. The initial manifestations of the disease on the mucosa of the oral cavity are erythema and edema, against which background subepithelial blisters appear, different in size and localization, with serous contents and a grayish-white dense lid. Salivation increases, there are painful sensations when eating. At the end of one or two days, the blisters are opened, forming quite extensive painful erosions, covered with fibrinous yellowish coating, which begin to bleed when trying to remove it.

The defeat of the corners of the mouth and the red border of the lips is often accompanied by swelling. Bubbling rashes on the lips are opened quickly enough after their appearance, and erosion is covered with coarse bloody crusts, which, due to the attachment of the secondary infection, acquire a dirty gray color. Because of the significant painfulness of these rashes, patients are difficult to swallow and speech, they can not normally open their mouths. Such a symptomatology persists from one and a half to three weeks.

Treatment of

For the successful treatment of exudative erythema multiforme, it is necessary to eliminate foci of infection, sanation of the organism, in the case of the medicinal nature of the occurrence, removal of the medicine that caused the disease.

During the first two or three days, bed rest is shown. Intravenous administration of 10 ml of 10% calcium chloride is indicated;Tableted prescribe 1 g 4 times a day of sodium salicylate, antihistamines( fenkarol, tavegil, suprastin, dimedrol).In more severe cases, the reception of broad-spectrum antibiotics and corticosteroids, intravenous drip-haemodes, rheopolyglucin, etc. is indicated. Compulsory administration of vitamins( PP, C and group B) is mandatory.

Local treatment aims to accelerate the epithelialization of erosion, as well as the elimination of edema and inflammation. On the eroded surfaces apply applications of anesthetizing solutions and solutions of enzymes( chymotrypsin, trypsin), weak antiseptic solutions are carried out irrigation of the oral cavity;Ointments containing keratoplastic agents( sea buckthorn oil, dog rose, carotolin) and corticosteroids are applied to the mucous membrane of the oral cavity and to the lips. Local treatment should be done every three hours.