jesus made changes sa last slide table and the circles site of predilection
Download
Skip this Video
Download Presentation
Jesus, made changes sa last slide (table) and the circles (site of predilection)

Loading in 2 Seconds...

play fullscreen
1 / 13

Jesus, made changes sa last slide (table) and the circles (site of predilection) - PowerPoint PPT Presentation


  • 105 Views
  • Uploaded on

Jesus, made changes sa last slide (table) and the circles (site of predilection). Do we need to distinguish kung EM Minor or Major ung patient?. ERYTHEMA MULTIFORME. Erythema Multiforme. EM minor & EM with mucosal involvement Self-limited, recurrent disease

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about ' Jesus, made changes sa last slide (table) and the circles (site of predilection)' - vlad


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
jesus made changes sa last slide table and the circles site of predilection

Jesus, made changes sa last slide (table) and the circles (site of predilection)

Do we need to distinguish kung EM Minor or Major ung patient?

erythema multiforme1
Erythema Multiforme

EM minor & EM with mucosal involvement

  • Self-limited, recurrent disease
  • No or only a mild prodrome (1 to 4 weeks)
  • Sharply marginatederythematousmacules become raised, edematous papules (24 to 48 hours)
  • Koebner’s phenomenon or photoaccentuation
  • Mucosal involvement in 25%

-- usually limited to the oral mucosa

  • More severe classic case? Two or more mucous membranes involved in 45%
em minor
EM Minor

Characteristic & Evolution of the Lesion

  • Periphery: ring of erythema
  • Central: flatters, more pruritic and dusky
  • “target” or “iris” lesion with three zones
  • Central dusky purpura
  • Elevated, edematous, pale ring
  • Surrounding macular erythema
em minor1
EM Minor

Sites of Predilection

(Symmetrical and acral)

  • (Best observed on) Palms and soles
  • Dorsal feet
  • Extensor limbs
  • Elbows
  • Knees

Age of Predilection

  • young adults
erythema multiforme2
Erythema Multiforme

Steven-Johnson syndrome / EM major

  • Clinically different from minor
  • Frequently, febrile prodrome
em major
EM Major

Characteristic & Evolution of the Lesion

  • Flat, erythematous or purpuric macules

incomplete “atypical targets” (may blister centrally

  • Larger and more commonly confluent lesions compared to EM minor
em major1
EM Major

Sites of Predilection

  • Begins diffusely on the trunk and mucous membranes
  • Spreads centripetally

Age of Predilection

  • Eruption occurs at all ages
etiologic factors
Etiologic Factors
  • EM minor = herpes simplex infection
    • Typically orolabial
    • 1 to 3 weeks (10 day average) after herpes lesion
    • May or not follow herpes outbreaks
  • EM major(SJS) = medications
    • Most centrally accentuated eruptions with atypical targets
    • Sulfonamides, antibiotics, NSAIDs, allopurinol, anticonvulsants
    • Due to abnormal metabolism of medications
etiologic factors1
Etiologic Factors
  • Also, EM major= Mycoplasmapneumoniae
    • Prominent mucosal involvement and bullous skin lesions – NOT classic iris lesions
    • Resemble SJS cases
  • And, EM major = radiation therapy
    • With phenytoin and tapering corticosteroids – induces EM starting at radiation port
pathogenesis
Pathogenesis
  • Activated T lymphocytes
    • Epidermis: cytotoxic or suppressor cells
    • Dermis: helper T cells
  • EM minor – specific HLA types (HLA-DQ3)
  • SJS – abnormalities in drug metabolism

Hence, there is a genetic component for both diseases

disease
Disease

Diagnosis

  • Physical examination
    • Characteristic Target Lesions
    • Distribution- symmetrical and acral
    • Evolution:

Center becomes darker and purpuric

Lesions flatten at the center

Ring of Erythema

ad