Lesions of the skin, mucous membranes in humans are manifestations of multiforme exudative erythema. This acute disease, characterized by the occurrence of polymorphic rashes, has a relapsing course. Often this disease affects people of young and middle age, less often diagnosed in children. Such an ailment is a fairly common disease, which usually manifests itself during the off-season.
Such terminology is used by specialists to note rashes that are similar to each other, which tend to progress as a result of certain diseases that have an infectious nature or an allergic reaction. In this case, two forms of the disease are determined:
- toxic-allergic exudative erythema;
- infectious and allergic.
So, for what reasons does multiforme exudative erythema arise (ICD-10 code L51)? Let's figure it out together.
Causes
At the moment, experts have not yet precisely identified the causes that provoke the development of an infectious-allergic form of the disease. But most argue that the cause of the disease is a focal infection already present in the human body. A similar factor is observed in approximately 70% of patients diagnosed with this form of the disease. In such people, high sensitization to infectious pathogenic microorganisms is found. During the formation of a relapse of the disease, the stability of the immune system drops significantly.
What is the most likely nature of erythema multiforme exudative disease?
Experts believe that the main reason for the development of an infectious-allergic form is the immunodeficiency state, which 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 use of pharmaceuticals from different groups. In most cases, the body thus reacts to drugs from the tetracycline series, barbiturates.
Toxic-allergic form
Toxic-allergic form of erythema multiforme exudative. In these cases, there is a clear hyperemia of the foci. They also have the ability to merge. Often exposed to mucous membranes (genital mucosa, oral cavity and others). Bubbles are an epidermolitic component.
Infectious and allergic form
In this case, small pathological manifestations appear 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 oral cavity and genitals. This form of pathology is most often observed, it is not difficult to diagnose. Specialists 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 produce exacerbations.
And the most serious and severe form of this ailment is Stevens-Johnson syndrome. Together with lesions of the mucous membranes and skin, the eyes, nose and genitals are affected. If the appropriate treatment is not started in time, then a fatal outcome is quite possible.
Symptomatology
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, multiforme exudative erythema is particularly difficult. Symptoms are the same in adults and children. Therefore, it is very important when identifying the first signs of the development of the disease immediately deliver the child to the hospital for an appointment with a specialist. Symptoms of the pathology of an infectious-allergic form:
- malaise;
- headache;
- sore 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 particular place, for example, only on the lips or only on the genitals. Intoxication symptoms of multiforme exudative erythema disappear 3-5 days after the rash, and the temperature can last up to three weeks.
On the mucous membrane of the mouth and on the skin, limited edema spots or papules appear. Usually they are reddish pink. Such formations are rapidly increasing 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 vesicles can also form, in which exudate is contained inside. Patients usually complain of itching, more often note a burning sensation.
Oral erythema multiforme
The clinical picture of this type of exudative erythema, as a rule, is more monotonous. But this form of the disease is much more difficult, because the symptoms are very pronounced. The most “favorite” localizations of rashes are cheeks, lips, palate, and the vestibule of the mouth. All this is rather unpleasant and significantly reduces the quality of life.
It should be noted here that such a disease begins suddenly and acutely. At the initial stages of development, spilled and edematous erythema forms on the mucous membrane of the mouth, which eventually turns into vesicles after a few days. After a few days, 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 grayish-yellow coating. It is easy to separate, but after removal, parenchymal bleeding forms .
Often with multiforme exudative erythema, bloody thick crusts form on the lips that do not allow you to fully open your mouth. It should be noted that in some patients, erosion can spread to the entire mucous membrane of the mouth, while in others only single rashes appear.
Signs of severe mucosal damage
With severe damage to the oral mucosa, the following symptoms are observed:
- it is impossible to open your mouth completely;
- sharp pain;
- inability to take even liquid food;
- it's hard to talk;
- exudate is released in large quantities from erosion surfaces;
- salivation increases.
Consider the second form of erythema multiforme exudative.
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. The foci can be both widespread and fixed. If rashes are common, the oral mucosa is often affected.
Fixed rashes are formed in those places where they 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 a high sensitivity to drugs is satisfied. It should be noted that vesicles can appear on an unchanged skin area or mucous membrane.
This form of pathology occurs regardless of the season. And she is not preceded by any symptoms. In very rare cases, the temperature may rise slightly.
Clinical recommendations for erythema multiforme exudative should be strictly followed. We will give 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 rash biopsy or fingerprint smears. This may make it possible to refute other pathologies.
Differential diagnosis of multiforme exudative erythema is carried out with these pathologies:
- Dühring's disease.
- Secondary syphilis.
- Lichen planus.
- Pemphigoid.
- Pemphigus.
What is the treatment of erythema multiforme exudative?
Treatment of exudative erythema
Pathology in adults and children is treated in almost the same way:
- if allergies to food are detected, enterosorbents are indicated;
- the effect of food allergens and medicines should be completely eliminated;
- if 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 appeared with erythema, then antibiotics of a wide spectrum of action are recommended for the course of treatment;
- use ointments and aerosols with anesthetic 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, only it needs to be done systematically.
The treatment of the disease is carried out in stationary conditions and under the constant supervision of doctors.
Sometimes they can prescribe folk remedies, as a way of adjuvant therapy. But you cannot use them yourself, since this can only worsen the situation. Therapy with folk remedies can only be prescribed by the attending physician.
Diet for this pathology
With any form of the disease, a diet is also prescribed, which should exclude these products from the diet:
- nuts
- fruits, especially citrus fruits, vegetables of red and orange color, including tomatoes;
- fish, especially red and seafood;
- eggplant and mushrooms;
- poultry meat and products made from it;
- chocolate, honey, pastry;
- smoked products, hot and extractive products, horseradish, radish, marinades, spices, pickles, mustard;
- coffee and alcoholic drinks.
The following types of foods can be consumed:
- cereal and vegetable soups, cereals with the addition of butter and vegetable oil;
- fresh cucumbers, dill, parsley, baked apples and watermelon;
- unbread wheat;
- compotes from fresh apples, cherries, dried fruits and plums;
- weakly brewed teas;
- one day lactic acid products.
If the oral cavity is affected by this pathology, then rubbed and liquid dishes are used. In addition, heavy drinking is indicated. If it is not possible to swallow parenteral nutrition.
Treatment with folk remedies involves the use of:
- decoctions of chamomile;
- decoctions of arnica (ram);
- ointments from arnica.
Only if complex therapy is used will there be a result.