Erythema multiforme

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Erythema multiforme, circular lesions - hands	Erythema multiforme, target lesions on the palm	Erythema multiforme on the hand	Erythema multiforme on the hands
Erythema multiforme on the leg	Exfoliation following erythroderma

Lyell's syndrome; Stevens-Johnson syndrome; Toxic epidermal necrolysis

• Multiple skin lesions:
  • With sudden onset, which may recur
  • That may spread
  • That may appear as nodule, papule, or macule
  • Central lesion surrounded by concentric rings of paleness and redness, also called "target", "iris", or "bull's eye"
  • May have vesicles and bullae (blisters of various sizes)
  • Located on the legs, arms, palms, hands, or feet
  • May involve the face or lips
  • Trunk is usually not involved
  • Usually symmetrical
• Itching of the skin may be present
• Fever
• General ill feeling
• Joint aches

• Vision abnormalities
• Dry eyes
• Bloodshot eyes
• Eye pain
• Eye burning, itching and discharge
• Mouth sores

The diagnosis is primarily based on the appearance of the skin lesion and its typical symmetrical distribution, especially if there is a history of risk factors or associated diseases.

There may be a positive Nikolsky's sign.

A skin lesion biopsy and microscopic examination may be helpful to differentiate erythema multiforme from other disorders. Erythema multiforme may show tissue death and other changes. Microscopic examination of the tissue may also show antibody deposits.

Review Date: 10/16/2006
Reviewed By: Michael S. Lehrer, M.D., Department of Dermatology, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network.