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Therapeutic Approach

Erythema multiforme (EM) is an acute mucocutaneous syndrome originally described by von Hebra in 1860 as erythema exudativum multiforme. The condition is infrequent and the course is usually mild and self-limited but carries a risk of relapse. Based on the degree of mucous membrane involvement, EM is separated into EM minus (EMm) if only skin and lips are involved, and EM majus (EMM) when mucous membranes are affected. EMM differs from Stevens-Johnson syndrome and is further differentiated in typical EMM with targets in mainly acral distribution, which is often caused by herpes simplex eruptions, and atypical EMM with target lesions in widespread distribution, which is frequently induced by mycoplasma pneumoniae. Respiratory infections of other (partly unknown) origin may also trigger EM. Therapy includes supportive care and topical and anti-infective treatments. Sometimes immunomodulating therapy is used.1-4 See Table 29-1.

Table 29-1Erythema Multiforme Treatment Table

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