Exudative erythema
Causes and symptoms of exudative erythema
What is exudative erythema?
Exudative erythema multiforme is one of the clinical forms of erythema, characterized by an acute course, the formation of a polymorphic rash on the skin and mucous membranes, and a tendency to relapse (especially in the autumn and spring periods). Also, this term is used to denote rashes with similar clinical manifestations that develop due to an allergy to any drug or in certain infectious diseases. Thus, there are two forms of exudative erythema: infectious-allergic and toxic-allergic.
The disease is more common among young people and middle-aged people.
Causes of exudative erythema
The causes of exudative erythema are not well understood. Most often, patients simultaneously with infectious-allergic exudative erythema are diagnosed with focal infections, which include sinusitis, tonsillitis, pulpitis, and chronic appendicitis. Often, a factor in the development of the disease becomes an increased sensitivity to bacteria of staphylococcus, streptococcus, E. coli, etc.
Toxic-allergic exudative erythema arises mainly from individual intolerance to certain medications. These include barbiturates, amidopyrine, sulfonamide, tetracycline, etc. They influence the development of the disease and autoimmune processes in the human body.
Symptoms of exudative erythema
Exudative erythema multiforme usually has an acute onset. Its first symptoms are fever, excruciating headache, general symptoms of malaise (weakness, impaired appetite, pain in muscles and joints), and a sore throat may appear when coughing. The rash usually appears on the second day. They are localized on the mucous membranes, skin and lips.
The rash is pinkish patches and reddish papules that quickly grow to two to three centimeters. They tend to merge. Serous blisters usually appear in the center of the papules, which burst and form erosion. The rash is painful, the patient feels a burning sensation or itching.
The rash is localized mainly on the skin of the feet and palms, on the bends of the limbs, forearms, knees, genitals, elbows and knees.
Appearing on the mucous membranes, the rash gives a person much more inconvenience, because, opening, the bubbles form very painful wounds that tend to merge. Such erosive areas can cover the entire mucous membrane of the mouth and lips of a person. Sometimes the wounds are covered with a grayish-yellow coating, attempts to remove which cause parenchymal bleeding. At the same time, the patient suffers from severe salivation, pain, speech is difficult, and eating becomes impossible.
The skin rash usually lasts 10-15 days, after which it goes away on its own. The lesion of the mucous membrane has a less favorable course and passes only in the fourth or sixth week.
The infectious-allergic form of exudative erythema is prone to seasonal relapses. The disease affects people mainly in spring and autumn.
For the toxic-allergic form of the disease, previous general symptoms or relapses are not characteristic. The manifestation of the disease depends only on the person's contact with the allergen.
Treatment of exudative erythema
Exudative erythema multiforme is always an allergic reaction, therefore, in order to avoid a relapse of the disease, it is necessary to eliminate all contact with allergens. For food allergies, enterosorbents are prescribed. If erythema occurs along with any secondary infection, the patient is prescribed antibiotics. In the treatment of exudative erythema, corticosteroids (in severe cases), vitamins (B, C), and potassium preparations are also used. Antifungal drugs, pain relievers (ointments, aerosols, solutions) and antiseptics are also used.
The prognosis of treatment is favorable. Complications and deaths are possible only with the appearance of Stevens-Johnson syndrome. This is a severe variant of the course of exudative erythema, accompanied by prolonged fever, fusion of erosions on the mucous membranes with the formation of a single erosive bleeding area. The disease can affect the eyes, causing keratitis and conjunctivitis. Complications of this process are myocarditis and meningoencephalitis, as a result of which a lethal outcome can occur. Another option for a severe course of drug allergy is Lyell's syndrome, which causes epidermal exfoliation.
Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist
Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".
