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Minimal Erythema Dose MED Testing
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Current Perspectives on Erythema Multiforme.

Marianne Lerch1, Carlo Mainetti2, Benedetta Terziroli Beretta-Piccoli3

  • 1Allergy/Dermatology Unit, Department of Internal Medicine, Kantonsspital Winterthur, Winterthur, Switzerland.

Clinical Reviews in Allergy & Immunology
|January 21, 2018
PubMed
Summary
This summary is machine-generated.

Timely recognition and treatment of erythema multiforme (EM) are crucial. This review covers EM diagnosis, pitfalls, and novel treatments like JAK-inhibitors for improved clinical decision-making.

Keywords:
AcyclovirCoxsackie virusDrug reactionEpstein Barr virusErythema multiformeHepatitis C virusHerpes simplex virusMycoplasma pneumoniae

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Area of Science:

  • Dermatology
  • Immunology

Background:

  • Erythema multiforme (EM) diagnosis and treatment present significant clinical challenges.
  • Accurate identification and prompt management are essential for patient outcomes.

Purpose of the Study:

  • To summarize current diagnostic guidelines for erythema multiforme.
  • To highlight potential diagnostic pitfalls and review modern/novel therapeutic options.
  • To aid clinicians in making informed diagnostic and therapeutic decisions for erythema multiforme.

Main Methods:

  • Review of current literature on erythema multiforme diagnosis and treatment.
  • Analysis of diagnostic criteria, including clinical presentation (targetoid lesions, acral localization) and histology.
  • Examination of various triggers (infections, drugs) and therapeutic strategies.

Main Results:

  • Erythema multiforme diagnosis relies on characteristic targetoid lesions and histology.
  • Common triggers include herpes simplex virus, Mycoplasma pneumoniae, and various drugs (e.g., allopurinol, anticonvulsants, antibiotics, TNF-α inhibitors).
  • Novel treatments such as JAK-inhibitors and apremilast show promise for refractory cases.

Conclusions:

  • Effective management of erythema multiforme requires understanding its diverse presentations and triggers.
  • While acyclovir prophylaxis is often ineffective for recurrent cases, alternative treatments like dapsone, JAK-inhibitors, and apremilast offer new therapeutic avenues.