Lesions of the skin, mucous membranes in humans are manifestations of erythema multiforme exudative. This acute disease, characterized by the occurrence of polymorphic rashes, has a relapsing course. Often this disease affects young and middle-aged people, less often diagnosed in children. Such an ailment is a fairly common disease, which usually manifests itself during the off-season.
This terminology is used by specialists to mark similar rashes that tend to progress as a result of certain diseases that are of an infectious nature or an allergic reaction. In this case, two forms of the disease are determined:
- toxic-allergic exudative erythema;
- infectious-allergic.
So, what are the reasons for erythema multiforme exudative (ICD-10 code L51)? Let's figure it out together.
Reasons
At the moment, experts have not yet accurately identified the causes that provoke the development of an infectious-allergic form of the disease. But most argue that the cause of the development of the disease is a focal infection that is already present in the human body. A similar factor is observed in approximately 70% of patients who have been diagnosed with this form of the disease. Such people show high sensitization to infectious pathogenic microorganisms. During the formation of a relapse of the disease, the resistance of the immune system drops significantly.
What is the most likely nature of erythema multiforme disease?
Specialists believe that the main reason for the development of an infectious-allergic form is an immunodeficiency condition that arose due to:
- infection with viral infections;
- heliomagnetic effects;
- chronic infections;
- hypothermia.
One of the causes of the toxic-allergic form of the disease is the intake of pharmaceuticals from different groups. In most cases, the body reacts in this way to drugs from the tetracycline series, barbiturates.
Toxic-allergic form
Toxic-allergic form of exudative erythema multiforme. In these cases, there is a clear hyperemia of the foci. They also have the ability to merge. Mucous membranes are often exposed (genital mucosa, cavitymouth, etc.). The blisters are the epidermolytic component.
Infectious-allergic form
In this case, there are small pathological manifestations on the skin, which usually do not merge. In most cases, they are located on the lower extremities. Less commonly appear on the mucous membranes of the mouth and genitals. This form of pathology is observed most often, it is not difficult to diagnose it. Experts have also identified a huge number of infectious pathogens that provoke the development of the disease. Basically, these are microorganisms that form pathological foci of chronic viruses in the human body, which in turn periodically exacerbate.
And the most serious and severe form of this disease is Stevens-Johnson syndrome. Along with lesions of the mucous membranes and skin, the eyes, nose and genitals are also affected. If appropriate treatment is not started in time, then a fatal outcome is quite possible.
Symptomatics
Symptoms are determined depending on the form of the disease that a person has. Signs of manifestation are the same in both children and adults. It should be noted that in children, erythema multiforme exudative is especially difficult. The symptoms are the same in adults and children. Therefore, it is very important to immediately take the child to the hospital for an appointment with a specialist when identifying the first signs of the development of the disease. Symptoms of the pathology of the infectious-allergic form:
- malaise;
- headaches;
- pain in the throat and joints.
The nature of the rashes
Rashes appear on the skin. They are observed on the mucous membranes of the mouth, on the lips, on the genitals. It is important to consider that such rashes can be located only in one specific place, for example, only on the lips or only on the genitals. The toxic symptoms of erythema multiforme disappear 3-5 days after the onset of the rash, and the temperature can last up to three weeks.
Limited edematous spots or papules appear on the oral mucosa and on the skin. They are usually reddish-pink in color. Such formations quickly increase in size. The maximum size is 3 cm. The rash in the central part has a blue tint and sinks a little. In the center, characteristic bubbles can also form, which contain exudate inside. Patients usually complain of itching, more often they notice a burning sensation.
Multiform exudative erythema in the oral cavity
The clinical picture of this type of exudative erythema is usually more monotonous. But this form of the disease is much more severe, because the symptoms are very pronounced. The most "favorite" localizations of rashes are the cheeks, lips, palate, vestibule of the mouth. All this is quite unpleasant and reduces the quality of life to a large extent.
It should be noted here that such a disease begins suddenly and acutely. At the initial stages of development, a diffuse and edematouserythema, which eventually turns into vesicles after a few days. A few days later, these bubbles open and erosive areas appear. They can be quite large and cover the entire oral mucosa, affecting the lips. Such affected areas are often covered with a specific greyish-yellow coating. It is easy to separate, but after removal, parenchymal bleeding occurs.
Often, with erythema multiforme, bloody thick crusts form on the lips, which do not allow the mouth to be fully opened. It should be noted that in some patients, erosion can spread to the entire oral mucosa, while in others only single rashes appear.
Signs of severe mucosal damage
With severe damage to the oral mucosa, the following symptoms are observed:
- unable to fully open mouth;
- sharp soreness;
- not being able to take even liquid food;
- hard to talk;
- exudate is released from erosion surfaces in large quantities;
- drooling increases.
Let's consider the second form of erythema multiforme.
Toxic-allergic form of the disease
This form is characterized by the appearance of a rash, which can be visually compared with rashes of an infectious-allergic form. Foci can be either widespread or fixed. If the rash is widespread, the oral mucosa is often affected.
Rashes fixedare formed in those places where they were formed earlier, but this does not mean that they cannot appear in other places. Often, formations occur in the oral cavity, because it is in this area that the high sensitivity to drugs is satisfied. It should be noted that blisters may appear on an unchanged skin area or mucosa.
This form of pathology occurs regardless of the season. And it is not preceded by any symptoms. In very rare cases, the temperature may rise slightly.
Clinical guidelines for erythema multiforme exudative should be strictly followed. We will list them below.
Diagnosis of this pathology
The clinical picture of erythema is so clear and typical that the use of any additional methods in the study is not needed. Sometimes doctors may resort to a biopsy of the rash or smear-prints. This may provide an opportunity to refute other pathologies.
Differential diagnosis of erythema multiforme exudative is carried out with these pathologies:
- Duhring's disease.
- Secondary syphilis.
- Lichen planus.
- Pemphigoid.
- Pemphigus.
What is the treatment for erythema multiforme exudative?
Treatment of exudative erythema
Pathology in adults and children is treated almost according to the same scheme:
- if an allergy to food is detected, it is indicated to take enterosorbents;
- need completelyavoid exposure to food allergens and medications;
- if a skin rash is detected, use aniline solutions;
- if the disease is severe, then the treatment course is supplemented with injections and corticosteroid ointments;
- if an infection occurs with erythema, then broad-spectrum antibiotics are recommended for the course of treatment;
- use ointments and aerosols with analgesic effect for local treatment;
- vitamin therapy.
In order to quickly remove rashes in the oral cavity, you need to regularly use the Rotokan solution for rinsing. A solution of potassium permanganate and boric acid is also suitable. This method of treatment is quite effective, but you need to do it systematically.
Treatment of the disease is carried out in a hospital and under the constant supervision of doctors.
Sometimes folk remedies can be prescribed as a way of adjuvant therapy. But you can’t use them on your own, as this can only worsen the situation. Therapy with folk remedies can only be prescribed by the attending physician.
Diet for this pathology
For any form of the disease, a diet is also prescribed, which should exclude these products from the diet:
- nuts;
- fruits, especially citrus fruits, red and orange vegetables, including tomatoes;
- fish, especially red and seafood;
- eggplant and mushrooms;
- poultry meat and products made from it;
- chocolate, honey, rich flourproducts;
- smoked products, spicy and extractive products, horseradish, radish, marinades, spices, pickles, mustard;
- coffee and alcoholic drinks.
The following types of food can be consumed:
- cereal and vegetable soups, cereals with butter and vegetable oil;
- fresh cucumbers, dill, parsley, baked apples and watermelon;
- wheat lean bread;
- comotes from fresh apples, cherries, dried fruits and plums;
- poorly brewed teas;
- daily dairy products.
If the oral cavity is affected by this pathology, then pureed and liquid dishes are consumed. In addition, plentiful drinking is shown. If it is impossible to swallow, parenteral nutrition is carried out.
Treatment with folk remedies involves the use of:
- chamomile tea;
- decoction of arnica (sheep);
- arnica ointments.
Only if complex therapy is used, will there be a result.
