Causes of Erythema multiforme

List of causes of Erythema multiforme

Following is a list of causes or underlying conditions (see also Misdiagnosis of underlying causes of Erythema multiforme) that could possibly cause Erythema multiforme includes:

• Certain viral infections
• Certain bacterial infections
• Adverse reaction to vaccinations

Causes of Erythema multiforme (Diseases Database):

The follow list shows some of the possible medical causes of Erythema multiforme that are listed by the Diseases Database:

• Histoplasmosis
• Barbiturates
• Diltiazem
• Ibritumomab tiuxetan
• Staphylococcus aureus
• Herpes virus 2
• Thiabendazole
• Penicillamine
• Sulphonylureas
• Ethotoin
• Orf
• Mycoplasma pneumoniae
• Phenobarbital
• Nevirapine
• Sulphonamides
• Suramin
• Thiacetazone
• Carbamazepine
• Lamotrigine
• Leflunomide
• Phenylbutazone
• Staphylococcal scalded skin syndrome
• Streptomycin
• Sulphasalazine
• Chlormezanone
• Isoniazid
• Herpes simplex
• Primidone
• Terbinafine
• Systemic lupus erythematosus
• Procainamide
• Phenytoin
• Clindamycin

Source: Diseases Database

Causes of Erythema multiforme: Online Medical Books

16 MEDICAL BOOKS ONLINE! Review excerpts from medical books online, free, without registration, for more information about the causes of Erythema multiforme.

Oral Lesions: Differential Diagnosis
(In a Page: Signs and Symptoms)

• Aphthous stomatitis
  –Idiopathic
  –Recurrent, shallow, painful, spontaneously resolving oral ulcers
• Herpes stomatitis
  –Due to a primary outbreak of HSV-1
  –Severe gingivostomatitis with pain, redness, and erosions around the gum line
  –Recurrent oral HSV (“cold sores”) often occur at the lip border
  –Stress, sun exposure, and many other factors contribute to flare-ups
• Self-limited viral disease (e.g., herpangina, hand-foot-mouth disease)
  –Most often seen in children
  –Prodrome of malaise and fever followed by a 5–10 day outbreak of oropharyngeal erosions or vesicles is common
  • Chemotherapy drugs (especially 5-FU and methotrexate)
  • Squamous cell carcinoma should always be considered if a nonhealing ulcer or oral erosion is noted
  • Bullous diseases (e.g., pemphigoid, pemphigus, lichen planus)
    –Recurrent painful oral ulcers and erosions
    –Evaluate for other skin rashes suggestive of these disorders
    • Behçet syndrome
      –Uncommon but well-known cause of oral ulcers
      –Patients must exhibit other symptoms (e.g., uveitis, CNS problems, GI complaints, genital ulcers) before this diagnosis can be made
    • Allergic contact dermatitis to amalgams in dental work may result in buccal tenderness
    • Erythema multiforme (Stevens-Johnson syndrome)
      –Characterized by oral ulcers, ocular involvement, and simultaneous targetoid, erythematous, or bullous skin lesions
      –May be triggered by HSV infection, Mycoplasma infection, or drugs (e.g., phenytoin, sulfonamides)
      • Primary syphilis
        –Painless chancre
      • Agranulocytosis or leukopenia
      • Histoplasmosis (especially in immunosuppressed patients)

READ BOOK EXCERPT ONLINE »

Stomatitis: Differential Diagnosis
(In a Page: Signs and Symptoms)

• Aphthous stomatitis is the most common cause of recurrent oral lesions
  –Presents as gray-yellow tender ulcer in anterior part of oral cavity
  –Major, minor, and herpetiform subtypes
  –Herpetiform ulcers: Multiple vesicles on tip or sides of tongue

• Infectious stomatitis
  –Herpes simplex virus may present as a primary infection (herpetic gingivostomatitis) with ulcers/vesicles in anterior oropharynx or as a secondary infection with “fever blisters” on lips
  –Herpangina: Caused by coxsackievirus; results in 1–2 mm vesicles on soft palate that rupture to become white ulcers; seen primarily in children, may be associated with palmar and plantar lesions in hand-foot-and-mouth disease
  –Syphilis (condyloma lata) results in painless oral chancres on lips, buccal mucosa, gingival
  –Varicella or chicken pox
  –Condylomata acuminata (warts) and molluscum contagiosum lesions resemble their characteristic genital lesions
  –Primary HIV infection
  –Candidiasis
• Stomatitis in immunocompromised patients
  –Breakdown in epithelium results in superinfection by Candida, HSV, VZV, or CMV
  –May occur secondary to chemotherapy
• Stevens-Johnson syndrome
• Gangrenous stomatitis (acute necrotizing ulcerative gingivitis)
  –Also known as “trench mouth”
  –Primarily affects children with severe malnourishment or debilitation
  –Causative agent is most commonly a spirochete (e.g., Borrelia vincentii)
  –Presents as painful, red vesicle on gingiva; progresses to necrotic ulcer, then cellulitis

• Chronic granulomatous disease
• Behçet syndrome (presents as recurrent oral and genital ulcers)
• Lichen planus
• Vitamin C deficiency
• Cancers (e.g., mouth cancer, leukemia, mucositis following chemotherapy)

READ BOOK EXCERPT ONLINE »

Stomatitis: Differential Diagnosis
(In A Page: Pediatric Signs and Symptoms)

• Aphthous ulcers (idiopathic)
  –May be due to alteration of T-cell immune function
  –Triggers include dietary substances, stress, and illness
  –Nutritional deficiencies (iron, B vitamins) may play a role
  –May run in families, thus making it more difficult to distinguish from herpetic lesions that have been shared among family members
  –May be small or large, may be singular or grouped

• Infectious stomatitis
  –Coxsackievirus: Also known as hand-footand-mouth disease; all locations of lesions may not be present; usually seen in the summer and fall
  –Herpetic gingivostomatitis: Common in toddlers; may last a week or longer; generally accompanied by fever, lymphadenopathy; painful lesions may cause reduction in oral intake and resultant dehydration
  –Herpangina: Caused by an enterovirus rather than human herpesvirus; lesions are present primarily on the soft palate, anterior tonsillar pillars, and posterior pharynx
  –Trench mouth: also known as Vincent angina; caused by fusiform bacteria or spirochetes; causes necrotizing gingivostomatitis with pseudomembrane formation; found in developing nations and malnourished patients

• Hematologic disorders
  –Associated with leukemia
  –Associated with neutropenia secondary to chemotherapy for malignancy
  –Associated with cyclic neutropenia
• Behçet disease
• Stevens-Johnson syndrome
• Inflammatory bowel disease: May be found in Crohn disease or ulcerative colitis
• HIV
  –Alterations in T-cell immunity can lead to aphthous ulcers
  –HIV patients are more susceptible to herpetic infections

READ BOOK EXCERPT ONLINE »

Stomatitis and other oral infections: Causes and incidence
(Professional Guide to Diseases (Eighth Edition))

Acute herpetic stomatitis results from the herpes simplex virus. It’s common in children ages 1 to 3. The cause of aphthous stomatitis is unknown, but predisposing factors include stress, fatigue, anxiety, febrile states, trauma, and solar overexposure. This type is common in girls and female adolescents.

READ BOOK EXCERPT ONLINE »

Toxic epidermal necrolysis: Causes and incidence
(Professional Guide to Diseases (Eighth Edition))

In 80% of cases, TEN is determined to result from a drug reaction — most commonly to sulfonamides, penicillins, barbiturates, hydantoins, procainamide, isoniazid, nonsteroidal anti-inflammatory drugs, or allopurinol. Numerous other drugs have also been implicated, although 5% of patients with TEN report no drug use. It may also result from chemical exposure, viral infection, mycoplasma pneumonia, or immunization.

TEN may reflect an immune response, or it may be related to overwhelming physiologic stress (coexisting sepsis, neoplastic diseases, and drug treatment).

The annual worldwide incidence of TENS is 1 to 3 cases for every 1 million people.

READ BOOK EXCERPT ONLINE »

Staphylococcal scalded skin syndrome: Causes and incidence
(Professional Guide to Diseases (Eighth Edition))

The causative organism in SSSS is group 2 Staphylococcus aureus, primarily phage type 71, which produces exotoxins that cause detachment of the epidermis. Predisposing factors may include impaired immunity and renal insufficiency — present to some extent in the normal neonate because of immature development of these systems.

SSSS is most prevalent in infants age 1 to 3 months but may develop in children. It’s uncommon in adults.

READ BOOK EXCERPT ONLINE »

Erythema [Erythroderma]: Medical causes
(Professional Guide to Signs & Symptoms (Fifth Edition))

Allergic reactions

Foods, drugs, chemicals, and other allergens can cause an allergic reaction and erythema. A localized allergic reaction also produces hivelike eruptions and edema.

Anaphylaxis, a life-threatening reaction, produces relatively sudden erythema in the form of urticaria. It also produces flushing; facial edema; diaphoresis; weakness; sneezing; bronchospasm with dyspnea and tachypnea; shock with hypotension and cool, clammy skin; and possibly airway edema with hoarseness and stridor.

Burns

In thermal burns, erythema and swelling appear first, possibly followed by deep or superficial blisters and other signs of damage that vary with the severity of the burn. Burns from ultraviolet rays, such as sunburn, cause delayed erythema and tenderness on exposed areas of the skin.

Candidiasis

When this fungal infection affects the skin, it produces erythema and a scaly, papular rash under the breasts and at the axillae, neck, umbilicus, and groin (intertrigo). Small pustules commonly occur at the periphery of the rash (satellite pustulosis).

Cellulitis

This bacterial infection of the skin and subcutaneous tissue causes erythema, tenderness, and edema.

Dermatitis

Erythema commonly occurs in this family of inflammatory disorders. In atopic dermatitis, erythema and intense pruritus precede the development of small papules that may redden, weep, scale, and lichenify. These occur most commonly at skin folds of the extremities, neck, and eyelids.

Contact dermatitis occurs after exposure to an irritant. It quickly produces erythema and vesicles, blisters, or ulcerations on exposed skin.

In seborrheic dermatitis, erythema appears with dull red or yellow lesions. Sharply marginated, these lesions are sometimes ring shaped and covered with greasy scales. They usually occur on the scalp, eyebrows, ears, and nasolabial folds, but they may form a butterfly rash on the face or move to the chest or to skin folds on the trunk. This disorder is common in patients infected with the human immunodeficiency virus and in infants (cradle cap).

Dermatomyositis

This disorder, most common in women older than age 50, produces a dusky lilac rash on the face, neck, upper torso, and nail beds. Gottron’s papules (violet, flat-topped lesions) may appear on finger joints.

Erysipelas

This skin infection caused by group A beta-hemolytic streptococci is characterized by an abrupt onset of reddish, well-demarcated, tender, warm, sometimes elevated lesions, mainly on the face and neck but sometimes also on the extremities. Flaccid, pus-filled bullae may develop after 2 to 3 days. Extension into deeper tissues is rare. Other signs and symptoms include fever, chills, cervical lymphadenopathy, vomiting, headache, sore throat, warmth and tenderness in the affected area and, possibly, alopecia.

Erythema annulare centrifugum

Small, pink infiltrated papules appear on the trunk, buttocks, and inner thighs, slowly spreading at the margins and clearing in the center. Itching, scaling, and tissue hardening may occur.

Erythema marginatum rheumaticum

Associated with rheumatic fever, this disorder causes erythematous lesions that are superficial, flat, and slightly hardened. They shift, spread rapidly, and may last for hours or days, recurring after a time.

Erythema multiforme

This acute inflammatory skin disease develops as a result of drug sensitivity after an infection (most commonly herpes simplex or a mycoplasmal infection), allergies, or pregnancy. One-half of the cases are of idiopathic origin.

Erythema multiforme minor produces reddish pink iris-shaped, urticarial, localized lesions with little or no mucous membrane involvement. Most lesions occur on flexor surfaces of the extremities. Burning or itching may occur before or in conjunction with lesion development. Lesions appear in crops and last 2 to 3 weeks. After 1 week, they become flat or hyperpigmented. Early signs and symptoms may include a mild fever, cough, and sore throat.

Erythema multiforme major usually occurs as a drug reaction; causes widespread symmetrical, bullous lesions that may become confluent; and includes erosions of the mucous membranes. Erythema is characteristically preceded by blisters on the lips, tongue, and buccal mucosa and a sore throat. Additional early signs and symptoms include cough, vomiting, diarrhea, coryza, and epistaxis. Later signs and symptoms include fever, prostration, difficulty with oral intake because of mouth and lip lesions, conjunctivitis due to ulceration, vulvitis, and balanitis. The most severe form of this disorder is known as Stevens-Johnson syndrome, a multisystem disorder that can occasionally be fatal. In addition to all signs and symptoms mentioned above, patients develop exfoliation of the skin from disruptions of bullae, although less than 10% of the body surface area is affected. These areas resemble second-degree thermal burns and should be cared for as such. Fever may rise to 102 ° F to 104° F (38.9° C to 40° C). The patient may also experience tachypnea; a weak, rapid pulse; chest pain; malaise; and muscle or joint pain.

Erythema nodosum

Sudden bilateral eruption of tender erythematous nodules characterizes this disorder. These firm, round, protruding lesions usually appear in crops on the shins, knees, and ankles but may occur on the buttocks, arms, calves, and trunk as well. Other effects include mild fever, chills, malaise, muscle and joint pain and, possibly, swollen feet and ankles. Erythema nodosum is associated with various diseases, most notably inflammatory bowel disease, sarcoidosis, tuberculosis, and streptococcal and fungal infections.

Frostbite

First-degree frostbite turns the affected body part a lifeless gray color, followed by an intense bluish red flush on rewarming. Blisters, lack of feeling, and tissue necrosis may follow.

Gout

This disease, which generally affects men ages 40 to 60, is characterized by tight and erythematous skin over an inflamed, edematous joint.

Intertrigo

In this superficial fungal infection, skin friction usually causes symmetrical erythema that may be accompanied by soreness and itching. Typically, erythema occurs in skin folds, such as in the groin; in severe cases, the skin may become bright red with erosion and maceration.

Kawasaki syndrome

This acute illness of unknown cause, which primarily affects children younger than age 5, commonly produces a rash or erythema. No test is available for Kawasaki syndrome, which can cause serious heart damage and death if not detected and treated immediately. Additional characteristic signs include fever, conjunctival injection, and lymphadenopathy. Patients are treated with I.V. gamma globulin.

Liver disease (chronic)

Any chronic liver disease, such as cirrhosis, can cause local vasodilation and palmar erythema along with jaundice, pruritus, spider angiomas, xanthomas, and characteristic systemic signs.

Lupus erythematosus

Both discoid and systemic lupus erythematosus (SLE) can produce a characteristic butterfly rash. This erythematous eruption may range from a blush with swelling to a scaly, sharply demarcated, macular rash with plaques that may spread to the forehead, chin, ears, chest, and other sun-exposed parts of the body.

In discoid lupus erythematosus, other signs and symptoms may include telangiectasia, hyperpigmentation, ear and nose deformity, and mouth, tongue, and eyelid lesions.

In SLE, acute onset of erythema may be accompanied by photosensitivity and mucous membrane ulcers, especially in the nose and mouth. Mottled erythema may occur on the hands, with edema around the nails and macular reddish purple lesions on the fingers. Telangiectasia occurs at the base of the nails or eyelids along with purpura, petechiae, ecchymoses, and urticaria. Other findings vary according to the body systems affected but typically include low-grade fever, malaise, weakness, headache, arthralgia, arthritis, depression, lymphadenopathy, fatigue, anorexia, weight loss, nausea, vomiting, diarrhea, and constipation.

Necrotizing fasciitis

This streptococcal infection usually begins with an area of mild erythema at the site of insult, which soon changes from red to purple and then blue. The appearance of fluid-filled blisters and bullae indicates the rapid progression of the necrotizing process. By days 7 to 10, dead skin begins to separate at the margins of the erythema, revealing extensive necrosis of the subcutaneous tissue. Other findings include fever, hypovolemia and, in later stages, hypotension and respiratory insufficiency—signs of overwhelming sepsis that require supportive care.

Polymorphous light eruption

This condition produces erythema, vesicles, plaques, and multiple small papules on sun-exposed areas, which may later eczematize, lichenify, and excoriate. Pruritus may also occur.

Psoriasis

Silvery white scales over a thickened erythematous base usually affect the elbows, knees, chest, scalp, and intergluteal folds. The fingernails may become thick and pitted.

Raynaud’s disease

In this disorder, the skin on the hands and feet typically blanches and cools after exposure to cold and stress and later becomes warm and purplish red.

Rheumatoid arthritis

In a flare-up of this disorder, erythema occurs over the affected joints along with heat, swelling, pain, and stiffness. Earlier symptoms include malaise, fatigue, myalgia, prolonged morning stiffness, and clumsiness. As the disease progresses, muscle atrophy, palmar erythema, generalized edema, mottled skin, and structural deformities occur.

Rosacea

Scattered erythema initially develops across the center of the face, followed by superficial telangiectases, papules, pustules, and nodules. Rhinophyma may occur on the lower half of the nose.

Rubella

Typically, flat solitary lesions join to form a blotchy pink erythematous rash that spreads rapidly to the trunk and extremities in this disorder. Occasionally, small red lesions (Forschheimer spots) occur on the soft palate. Lesions clear in 4 to 5 days. The rash usually follows a fever (up to 102° F [38.9° C]), headache, malaise, sore throat, a gritty eye sensation, lymphadenopathy, pain in the joints, and coryza.

Staphylococcal scalded skin syndrome

This endotoxin-mediated epidermolytic disease is caused by a clinically unapparent Staphylococcus aureus infection and primarily affects infants (Ritter’s disease) and small children. It’s characterized by erythema and widespread exfoliation of superficial epidermal layers, resembling scalded skin. Associated signs and symptoms include low-grade fever and irritability. Care must be taken to maintain hydration and prevent secondary infections of denuded areas; hospitalization is commonly required. Death may occur, especially in infants with extensive disease.

Thrombophlebitis

Although this disorder is sometimes asymptomatic, it can produce erythema over the inflamed vein. Fever, chills, and malaise may accompany severe localized pain, warmth, and induration; distal edema; and a positive Homans’sign.

Toxic shock syndrome

This infectious disorder, which is caused by a toxin-producing S. aureus infection, causes sudden, diffuse erythema in the form of a macular rash. It’s accompanied by a sudden high fever, myalgia, vomiting, severe diarrhea, and sudden hypotension that may lead to shock. Desquamation occurs after 1 to 2 weeks, especially on the palms and soles. This syndrome usually affects young women and has been associated with the use of tampons during menses.

Other causes

Drugs

Many drugs commonly cause erythema. (Drugs associated with erythema.)

Herb Alert

Ingestion of the fruit pulp of ginkgo biloba can cause severe erythema and edema of the mouth and rapid formation of vesicles. St. John’s wort can cause heightened photosensitivity, resulting in erythema or “sunburn.”

Radiation and other treatments

Radiation therapy may produce dull erythema and edema within 24 hours. As the erythema fades, the skin becomes light brown and mildly scaly. Any treatment that causes an allergic reaction can also cause erythema.

READ BOOK EXCERPT ONLINE »

Oral Lesions: Differential Overview
(Field Guide to Bedside Diagnosis)

Ulceration

❑ Aphthous ulcers

❑ Angular cheilitis

❑ Herpes simplex

❑ Traumatic ulcers

❑ Impetigo

❑ Erythema multiforme

❑ Mucositis

❑ Lichen planus

❑ Squamous cell cancer

❑ Syphilis

❑ Coxsackievirus A

❑ Herpes zoster

❑ Primary HIV

❑ Crohn disease

❑ Behçet syndrome

❑ Acute leukemia

❑ Pemphigoid

Glossitis

❑ Vitamin B₁₂ deficiency

❑ Folate deficiency

❑ Niacin deficiency

❑ Riboflavin deficiency

❑ Leukoplakia

❑ Candida

❑ Geographic tongue

❑ Black hairy tongue

❑ Scarlet fever

❑ Kwashiorkor

❑ Polyarteritis nodosa

Macroglossia

❑ Myxedema

❑ Angioedema

❑ Acromegaly

❑ Amyloidosis

Clinical Findings

Aphthous ulcers  They occur on nonkeratinized mucosa as single lesions or clusters of small, shallow, painful, clearly defined ulcers with an erythematous halo and a white base. There are usually no systemic symptoms or lymphadenopathy. These ulcers stereotypically recur.

Angular cheilitis  Tender fissuring at the corner of the mouth can be caused by Candida and either iron or vitamin B₁₂ deficiency.

Herpes simplex  An acute outbreak consists of labial vesicles that rupture and crust, and intraoral vesicles that quickly ulcerate. The lesions are usually quite painful and associated with fever, malaise, pharyngitis, and tender cervical lymphadenopathy. Recurrent lesions usually occur at the vermilion border and are preceded by localized burning dysesthesias.

Traumatic ulcers  These ulcers occur at the bite margin or adjacent to dentures.

Impetigo  Perioral painful shallow erosions spread rapidly. They are red and weeping, with honey-colored crusts.

Erythema multiforme  The onset is rapid and progresses to systemic toxicity. Intraoral ruptured bullae surrounded by erythema become painful mucosal erosions with gray exudate. Hemorrhagic crusts appear on the lips. An extensive maculopapular rash develops on the extensor surfaces and is characterized by target and polycyclic lesions and persisting urticarial plaques. Target lesions on the hands and feet are pathognomonic.

Mucositis  Initially there is a burning with diffuse mucosal redness and shininess that progresses to painful ulcers, then the tongue and buccal mucosa become denuded. There may also be a yellow pseudomembrane or hemorrhagic crust. This condition is found with Stevens-Johnson syndrome, agranulocytosis, and cancer chemotherapy.

Lichen planus  Lacy mucosal striae break down into painful erosions. This is often associated with drugs such as chloroquine, furosemide, gold, lithium, methyldopa, phenothiazines, propranolol, quinidine, spironolactone, tetracycline, or thiazides.

Squamous cell cancer  The ulcer is painless, malodorous, and indolent. It arises in an area of leukoplakia, bleeds easily, and has an elevated, indurated border. The presenting symptom is often pain, which may be referred to the ear, or dysphonia.

Syphilis  A primary chancre is a painless ulcer with an indurated copper border and unilateral lymphadenopathy. Secondary lesions are linear “snail track” ulcers and gray mucous patches on the lips, tonsils, and palate. There is concurrent generalized rash and fever. A tertiary gumma is a firm, broad, ulcerated plaque that may produce palatal perforation.

Coxsackievirus A  Herpangina presents with fever, sore throat, and grayish-white vesicles with a red halo, which quickly ulcerate. Hand, foot, and mouth disease (A16) has similar pharyngeal lesions accompanied by other lesions in the forenamed distribution.

Herpes zoster  A vesicular eruption with ulceration stops at the midline. Vesicles will also be present on the lower midface. Burning pain is characteristic.

Primary HIV  The most common presentation is a febrile mononucleosislike illness. Acute gingivitis and ulceration may be part of the spectrum.

Crohn disease  Oral ulcers may occur when intestinal disease is active, with symptoms of diarrhea, mucus, and blood.

Behçet syndrome  Multiple aphthous ulcers of the mouth occur with uveitis and genital ulcers.

Acute leukemia  Gingival swelling and superficial ulceration occur; hyperplasia, hemorrhage, and necrosis ensue. Deep ulcers may occur elsewhere on the mucosa, and they often become secondarily infected.

Pemphigoid  Painful grayish-white collapsed vesicles or bullae ulcerate when on the gingiva. Bullae may also involve the eyes, urethra, vagina, or rectum.

Vitamin B₁₂ deficiency  The tongue is beefy red, smooth, edematous, and painful. Pinpoint dots occur as a result of hyperemic capillaries and atrophied papillae. Peripheral neuropathy is commonly concurrent.

Folate deficiency  It is similar in presentation to B₁₂ deficiency but occurs more rapidly with nutritional depletion (e.g., alcoholics).

Niacin deficiency  Pellagra produces a burning sensation with hot or spicy food, without a visible abnormality early in the course. Later there is an increase in papilla and redness of the tongue’s tip and sides, and then fiery redness and swelling with desquamation occur. It is associated with severe watery diarrhea, red skin eruptions, and confusion.

Riboflavin deficiency  When advanced, the tongue looks magenta. Associated findings include a “shark skin” nose and conjunctival injection.

Leukoplakia  Early lesions are thin, pearly, and crinkled, especially on the lateral border of the tongue. A white-gray thickened epithelium without papillae appears later. Oral hairy leukoplakia is a sentinel finding of HIV infection, and is caused by concurrent EBV infection.

Candida  The tongue is bright red with cottage cheese-like material on the surface. Predisposing conditions include diabetes, dentures, recent antibiotics, or chemotherapy. In the absence of these factors, or severe or recalcitrant disease, HIV should be considered.

Geographic tongue  The surface has a changing demarcated pattern. There may be oral discomfort or burning. This finding is present in serious illness with antibiotic use.

Black hairy tongue  Elongated filiform papillae which may be discolored a yellow to brownish tone create the appearance. Associated conditions include antibiotic use, oral candidiasis, and poor oral hygeine.

Scarlet fever  A “strawberry tongue” occurs in a patient with a confluent rash that has the texture of fine sandpaper.

Kwashiorkor  Glossitis occurs early and is later accompanied by generalized edema and ascites.

Polyarteritis nodosa  The patient presents with a diffusely inflamed, orange-red tongue that has a burning sensation.

Myxedema  In addition to tongue enlargement, facial and pretibial skin is coarse, the voice is low and husky, and the relaxation phase of the deep tendon reflexes is delayed.

Angioedema  Acute edema of tissues frequently includes the tongue. Similar findings may occur with food allergies (e.g., shellfish), drug reactions (penicillin), and serum sickness.

Acromegaly  Tissues are generally thickened, and tongue enlargement is associated with jaw protrusion, malocclusion, and teeth that are widely spaced and tilt outward.

Amyloidosis  Tongue enlargement occurs with enlargement of other viscera and with peripheral neuropathy.

READ BOOK EXCERPT ONLINE »

Patterned Erythema: Differential Overview
(Field Guide to Bedside Diagnosis)

Figurate

❑ Tinea corporis

❑ Urticaria

❑ Erysipelas

❑ Erythema migrans

❑ Secondary syphilis

❑ Livedo reticularis

❑ Erythema multiforme

❑ Cutaneous larva migrans

❑ Granuloma annulare

❑ Erythema marginatum

Photodistribution

❑ Sunburn

❑ Drugs

❑ Polymorphous light eruption

❑ Systemic lupus erythematosus

❑ Porphyria cutanea tarda

❑ Pellagra

Differentiate from Cellulitis

❑ Insect bite

❑ Acute gout

❑ Deep vein thrombophlebitis

❑ Erythema migrans

❑ Fixed drug eruption

❑ Pyoderma gangrenosa

❑ Sweet syndrome

❑ Necrotizing fasciitis

READ BOOK EXCERPT ONLINE »

Stomatitis and other oral infections: Causes
(Handbook of Diseases)

Acute herpetic stomatitis results from herpes simplex virus. The cause of aphthous stomatitis is unclear.

READ BOOK EXCERPT ONLINE »

Staphylococcal scalded skin syndrome: Causes
(Handbook of Diseases)

The causative organism in SSSS is Group 2 Staphylococcus aureus, primarily phage type 71. Predisposing factors may include impaired immunity and renal insufficiency — present to some extent in the normal neonate because of immature development of these systems.

READ BOOK EXCERPT ONLINE »

Erythema: Medical causes
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)

Allergic reactions

Foods, drugs, chemicals, and other allergens can cause an allergic reaction and erythema. A localized allergic reaction also produces hivelike eruptions and edema.

Anaphylaxis, a life-threatening condition, produces relatively sudden erythema in the form of urticaria. It also produces flushing; facial edema; diaphoresis; weakness; sneezing; bronchospasm with dyspnea and tachypnea; shock with hypotension and cool, clammy skin; and possibly airway edema with hoarseness and stridor.

Burns

With thermal burns, erythema and swelling appear first, possibly followed by deep or superficial blisters and other signs of damage that vary with the severity of the burn. Burns from ultraviolet rays, such as sunburn, cause delayed erythema and tenderness on exposed areas of the skin.

Candidiasis

When candidiasis — a fungal infection — affects the skin, it produces erythema and a scaly, papular rash under the breasts and at the axillae, neck, umbilicus, and groin, also known as intertrigo. Small pustules commonly occur at the periphery of the rash (satellite pustulosis).

Cellulitis

Erythema, tenderness, and edema are a result of a bacterial infection of the skin (most commonly streptococcal and staphylococcal) and subcutaneous tissue.

Dermatitis

Erythema commonly occurs in this family of inflammatory disorders. With atopic dermatitis, erythema and intense pruritus precede the development of small papules that may redden, weep, scale, and lichenify. These occur most commonly at skin folds of the extremities, neck, and eyelids.

Contact dermatitis occurs after exposure to an irritant. It quickly produces inflammation, erythema and vesicles, blisters, or ulcerations on exposed skin.

With seborrheic dermatitis, erythema appears with dull red or yellow lesions. Sharply marginated, these lesions are sometimes ring shaped and covered with greasy scales. They usually occur on the scalp, eyebrows, ears, and nasolabial folds, but they may form a butterfly rash on the face or move to the chest or to skin folds on the trunk. This disorder is common in patients infected with the human immunodeficiency virus and in infants (cradle cap).

Dermatomyositis

Dermatomyositis, most common in females older than age 50, produces a dusky lilac rash on the face, neck, upper torso, and nail beds. Other symptoms include fever, malaise, and weakness. Gottron’s papules (violet, flat-topped lesions) may appear on finger joints.

Erythema annulare centrifugum

Small, pink, ring-shaped infiltrated papules appear on the trunk, buttocks, and inner thighs, slowly spreading at the margins and clearing in the center. Itching, scaling, and tissue hardening may occur.

Erythema marginatum rheumaticum

Associated with rheumatic fever, erythema marginatum rheumaticum causes erythematous lesions that are superficial, flat, and slightly hardened. They shift, spread rapidly, and may last for hours or days, recurring after a time.

Erythema multiforme

Erythema multiforme is an acute inflammatory skin disease that develops as a result of drug sensitivity after infection, most commonly herpes simplex and Mycoplasma; allergies; and pregnancy. One-half of the cases are of idiopathic origin.

Erythema multiforme minor has typical urticarial, red-pink, iris-shaped, localized lesions with little or no mucous membrane involvement. Most lesions occur on flexor surfaces of the extremities. Burning or itching may occur before or in conjunction with lesion development. Lesions appear in crops and last 2 to 3 weeks. After 1 week individual lesions become flat or hyperpigmented. Early signs and symptoms may include a mild fever, cough, and sore throat.

Erythema multiforme major usually occurs as a drug reaction; has widespread symmetrical, bullous lesions that may become confluent; and includes erosions of the mucous membranes. Erythema is characteristically preceded by blisters on the lips, tongue, and buccal mucosa and a sore throat. Additional signs and symptoms early in the course of the disease include cough, vomiting, diarrhea, coryza, and epistaxis. Later signs and symptoms include fever, prostration, difficulty with oral intake due to mouth and lip lesions, conjunctivitis due to ulceration, vulvitis, and balanitis.

The maximal variant of this disease is considered by many to be Stevens-Johnson syndrome. This is a multisystem disorder and can occasionally be fatal. In addition to all signs and symptoms mentioned above, patients develop exfoliation of the skin from disruptions of bullae, although less than 10% of the body surface area is affected. These areas resemble second-degree thermal burns and should be cared for as such. Fever may rise to 102° to 104°F (38.9° to 40° C). The patient may also experience tachypnea; weak, rapid pulse; chest pain; malaise; and muscle or joint pain.

Erythema nodosum

Sudden bilateral eruption of tender erythematous nodules characterizes erythema nodosum. These firm, round, tender, protruding lesions usually appear in crops on the shins, knees, and ankles but may occur on the buttocks, arms, calves, and trunk as well. Other effects include mild fever, chills, malaise, muscle and joint pain and, possibly, swollen feet and ankles. Erythema nodosum is associated with various diseases, most notably inflammatory bowel disease, sarcoidosis, tuberculosis, and streptococcal and fungal infections.

Gout

Gout, which generally affects males ages 40 to 60, is characterized by tight and erythematous skin over an inflamed, edematous joint.

Lupus erythematosus

Both discoid and systemic lupus erythematosus (SLE) can produce a characteristic butterfly rash. This erythematous eruption may range from a blush with swelling to a scaly, sharply demarcated, macular rash with plaques that may spread to the forehead, chin, ears, chest, and other sun-exposed parts of the body.

With discoid lupus erythematosus, telangiectasia, hyperpigmentation, ear and nose deformity, and mouth, tongue, and eyelid lesions may occur.

With SLE, acute onset of erythema may also be accompanied by photosensitivity and mucous membrane ulcers, especially in the nose and mouth. Mottled erythema may occur on the hands, with edema around the nails and macular reddish purple lesions on the fingers. Telangiectasia occurs at the base of the nails or eyelids, along with purpura, petechiae, ecchymoses, and urticaria. Joint pain and stiffness are common. Other findings vary according to the body systems affected but typically include low-grade fever, malaise, weakness, headache, arthralgias, arthritis, depression, lymphadenopathy, fatigue, weight loss, anorexia, nausea, vomiting, diarrhea, and constipation.

Psoriasis

Silvery white scales over a thickened erythematous base usually affect the elbows, knees, chest, scalp, and intergluteal folds. The fingernails may become thick and pitted.

Raynaud’s disease

Typically, the skin on the hands and feet blanches and cools after exposure to cold and stress. Later, it becomes warm and purplish red.

Rosacea

Scattered erythema initially develops across the center of the face, followed by superficial telangiectases, papules, pustules, and nodules. Rhinophyma may occur on the lower half of the nose.

Rubella

Typically, flat solitary lesions join to form a blotchy pink erythematous rash that spreads rapidly to the trunk and extremities in rubella. Occasionally, small red lesions (Forschheimer spots) occur on the soft palate. Lesions clear in 4 to 5 days. The rash usually follows fever (up to 102° F [38.9°C]), headache, malaise, sore throat, a gritty eye sensation, lymphadenopathy, pain in the joints, and coryza.

Other causes

Drugs

Many drugs commonly cause erythema. (See Drugs associated with erythema.)

Herbal remedies

Ingestion of the fruit pulp of ginkgo biloba can cause severe erythema and edema of the mouth and rapid formation of vesicles. St. John’s wort can cause heightened sun sensitivity, resulting in erythema or “sunburn.”

Radiation and other treatments

Radiation therapy may produce dull erythema and edema within 24 hours. As the erythema fades, the skin becomes light brown and mildly scaly. Any treatment that causes an allergic reaction can also cause erythema.

READ BOOK EXCERPT ONLINE »

Erythema: Medical causes
(Signs & Symptoms: A 2-in-1 Reference for Nurses)

Allergic reactions

Foods, drugs, chemicals, and other allergens can cause an allergic reaction and erythema. A localized allergic reaction also produces hivelike eruptions and edema.

Anaphylaxis, a life-threatening condition, produces relatively sudden erythema in the form of urticaria. It also produces flushing; facial edema; diaphoresis; weakness; sneezing; bronchospasm with dyspnea and tachypnea; shock with hypotension and cool, clammy skin; and possibly airway edema with hoarseness and stridor.

Burns

With thermal burns, erythema and swelling appear first, possibly followed by deep or superficial blisters and other signs of damage that vary with the severity of the burn. Burns from ultraviolet rays, such as sunburn, cause delayed erythema and tenderness on exposed areas of the skin.

Candidiasis

When candidiasis, a fungal infection, affects the skin, it produces erythema and a scaly, papular rash under the breasts and at the axillae, neck, umbilicus, and groin, also known as intertrigo. Small pustules commonly occur at the periphery of the rash (satellite pustulosis).

Cellulitis

With cellulitis, erythema, tenderness, and edema are a result of a bacterial infection of the skin and subcutaneous tissue. The patient typically feels pain and a warm sensation at the site of the infection.

Dermatitis

Erythema commonly occurs in dermatitis, a group of inflammatory disorders. With atopic dermatitis, erythema and intense pruritus precede the development of small papules that may redden, weep, scale, and lichenify. These occur most commonly at skin folds of the extremities, neck, and eyelids.

Contact dermatitis occurs after exposure to an irritant. It quickly produces erythema and vesicles, blisters, or ulcerations on exposed skin.

With seborrheic dermatitis, erythema appears with dull-red or yellow lesions. Sharply marginated, these lesions are sometimes ring shaped and covered with greasy scales. They usually occur on the scalp, eyebrows, ears, and nasolabial folds, but they may form a butterfly rash on the face or move to the chest or to skin folds on the trunk.

Erysipelas

Erysipelas — a skin infection caused by group A beta-hemolytic streptococci — is characterized by an abrupt onset on reddish, well-demarcated, tender, warm, sometimes elevated areas most commonly on the face and neck, although it may also occur on the extremities. Flaccid bullae that may be filled with pus may occur after 2 to 3 days. Associated signs and symptoms include fever, chills, local adenopathy, malaise, headache, and sore throat.

Erythema annulare centrifugum

With erythema annulare centrifugum, small, pink infiltrated papules appear on the trunk, buttocks, and inner thighs, slowly spreading at the margins and clearing in the center. Itching, scaling, and tissue hardening may also occur.

Erythema marginatum rheumaticum

Associated with rheumatic fever, erythema marginatum rheumaticum causes erythematous lesions that are superficial, flat, and slightly hardened. They shift, spread rapidly, and may last for hours or days, recurring after a time.

Erythema multiforme

Erythema multiform minor has typical urticarial red-pink, iris-shaped, localized lesions with little or no mucous membrane involvement. Most lesions occur on flexor surfaces of the extremities. Burning or itching may occur before or in conjunction with lesion development. Lesions appear in crops and last 2 to 3 weeks. After 1 week individual lesions become flat or hyperpigmented. Early signs and symptoms may include a mild fever, cough, and sore throat.

Erythema multiforme major usually occurs as a drug reaction; has widespread symmetrical, bullous lesions that may become confluent; and includes erosions of the mucous membranes. Erythema is characteristically preceded by blisters on the lips, tongue, and buccal mucosa and a sore throat. Additional signs and symptoms that occur early in the course of the disease include cough, vomiting, diarrhea, coryza, and epistaxis. Later signs and symptoms include fever, prostration, difficulty with oral intake due to mouth and lip lesions, conjunctivitis due to ulceration, vulvitis, and balanitis.

Erythema nodosum

Sudden bilateral eruption of tender erythematous nodules characterizes erythema nodosum. These firm, round, protruding lesions usually appear in crops on the shins, knees, and ankles but may occur on the buttocks, arms, calves, and trunk as well. Other effects include mild fever, chills, malaise, muscle and joint pain and, possibly, swollen feet and ankles. Erythema nodosum is associated with various diseases, most notably inflammatory bowel disease, sarcoidosis, tuberculosis, and streptococcal and fungal infections.

Frostbite

First-degree frostbite turns the affected body part a lifeless gray color, followed by an intense bluish red flush on rewarming. Blisters, lack of feeling, and tissue necrosis may follow.

Gout

Gout is characterized by tight and erythematous skin over an inflamed, edematous joint. The metatarsophalangeal joint of the great toe usually becomes inflamed first, followed by the instep, ankle, heel, knee, or wrist joints.

Intertrigo

With intertrigo, a superficial fungal infection, skin friction usually causes symmetrical erythema that may be accompanied by soreness or itching. Typically, erythema occurs in skin folds, such as in the groin; in severe cases, the skin may become bright red with erosion and maceration.

Liver disease (chronic)

Any chronic liver disease, such as cirrhosis, can cause local vasodilation and palmar erythema along with jaundice, pruritus, spider angiomas, xanthomas, and characteristic systemic signs.

Lupus erythematosus

Both discoid and systemic lupus erythematosus (SLE) can produce a characteristic butterfly rash. This erythematous eruption may range from a blush with swelling to a scaly, sharply demarcated, macular rash with plaques that may spread to the forehead, chin, ears, chest, and other sun-exposed parts of the body.

Telangiectasia, hyperpigmentation, ear and nose deformity, and mouth, tongue, and eyelid lesions may occur with discoid lupus erythematosus.

With SLE, acute onset of erythema may also be accompanied by photosensitivity and mucous membrane ulcers, especially in the nose and mouth. Mottled erythema may occur on the hands, with edema around the nails and macular reddish purple lesions on the fingers. Telangiectasia occurs at the base of the nails or eyelids, along with purpura, petechiae, ecchymoses, and urticaria. Joint pain and stiffness are common. Other findings vary according to the body systems affected but typically include low-grade fever, malaise, weakness, headache, arthralgias, arthritis, depression, lymphadenopathy, fatigue, weight loss, anorexia, nausea, vomiting, diarrhea, and constipation.

Polymorphous light eruption

Polymorphous light eruption produces erythema, vesicles, plaques, and multiple small papules on sun-exposed areas, which may later eczematize, lichenify, and excoriate. Pruritus may also occur.

Psoriasis

With psoriasis, silvery white scales that occur over a thickened erythematous base usually affect the elbows, knees, chest, scalp, and intergluteal folds. The fingernails may become thick and pitted.

Raynaud’s disease

With Raynaud’s disease, the skin on the hands and feet typically blanches and cools after exposure to cold and stress. Later, it becomes warm and purplish red. Numbness and tingling may also occur.

Rheumatoid arthritis

In a flare-up of rheumatoid arthritis, erythema occurs over the affected joints along with heat, swelling, pain, and stiffness. Earlier symptoms include malaise, fatigue, myalgia, prolonged morning stiffness, and clumsiness. As the disease progresses, muscle atrophy, palmar erythema, generalized edema, mottled skin, and structural deformities occur.

Rosacea

With rosacea, scattered erythema initially develops across the center of the face, followed by superficial telangiectases, papules, pustules, and nodules. Rhinophyma may occur on the lower half of the nose.

Rubella

With rubella, flat solitary lesions join to form a blotchy pink erythematous rash that spreads rapidly to the trunk and extremities. Occasionally, small red lesions (Forschheimer spots) occur on the soft palate. Lesions clear in 4 to 5 days. The rash usually follows fever (up to 102° F [38.9° C]), headache, malaise, sore throat, a gritty eye sensation, lymphadenopathy, pain in the joints, and coryza.

Staphylococcal scalded skin syndrome

Also known as Ritter’s disease, this disease occurs mainly in infants and small children. It’s caused by Staphylococcus aureus and is characterized by erythema and widespread exfoliation of superficial epidermal layers, resembling scalded skin. Associated signs and symptoms include low-grade fever and irritability. Death may occur, especially in infants with extensive disease.

Thrombophlebitis

Although thrombophlebitis sometimes produces no symptoms, it can produce erythema over the inflamed vein. Fever, chills, and malaise may accompany severe, localized pain, warmth, and induration; distal edema; and a positive Homans’sign.

Other causes

Drugs

Many drugs commonly cause erythema. (See Drugs associated with erythema.)

Radiation and other treatments

Radiation therapy may produce dull erythema and edema within 24 hours. As the erythema fades, the skin becomes light brown and mildly scaly. Any treatment that causes an allergic reaction can also cause erythema.

READ BOOK EXCERPT ONLINE »

Erythema [Erythroderma]: Medical causes
(Nursing: Interpreting Signs and Symptoms)

Allergic reaction.Foods, drugs, chemicals, and other allergens can cause an allergic reaction and erythema. A localized allergic reaction also produces hivelike eruptions and edema.

Anaphylaxis, a life-threatening condition, produces relatively sudden erythema in the form of urticaria. It also produces flushing; facial edema; diaphoresis; weakness; sneezing; bronchospasm with dyspnea and tachypnea; shock with hypotension and cool, clammy skin; and, possibly, airway edema with hoarseness and stridor.

Burns.With thermal burns, erythema and swelling appear first, possibly followed by deep or superficial blisters and other signs of damage that vary with the burn's severity. Burns from ultraviolet rays, such as sunburn, cause delayed erythema and tenderness on exposed areas of the skin.

Candidiasis.When candidiasis—a fungal infection—affects the skin, it produces erythema and a scaly, papular rash under the breasts and at the axillae, neck, umbilicus, and groin, also known as intertrigo. Small pustules commonly occur at the periphery of the rash (satellite pustulosis).

Cellulitis.Erythema, tenderness, and edema are a result of a bacterial infection of the skin and subcutaneous tissue.

Dermatitis.Erythema commonly occurs in this family of inflammatory disorders. With atopic dermatitis, erythema and intense pruritus precede the development of small papules that may redden, weep, scale, and lichenify. These occur most commonly at skin folds of the extremities, neck, and eyelids.

Contact dermatitis occurs after exposure to an irritant. It quickly produces erythema and vesicles, blisters, or ulcerations on exposed skin.

With seborrheic dermatitis, erythema appears with dull red or yellow lesions. Sharply marginated, these lesions are sometimes ring shaped and covered with greasy scales. They usually occur on the scalp, eyebrows, ears, and nasolabial folds, but they may form a butterfly rash on the face or move to the chest or to skin folds on the trunk. This disorder is common in patients infected with human immunodeficiency virus and in infants (cradle cap).

Dermatomyositis.Dermatomyositis produces a dusky lilac rash on the face, neck, upper torso, and nail beds. Gottron's papules (violet, flat-topped lesions) may appear on finger joints.

Erythema annulare centrifugum.Small, pink infiltrated papules appear on the trunk, buttocks, and inner thighs, slowly spreading at the margins and clearing in the center. Itching, scaling, and tissue hardening may occur.

Erythema marginatum rheumaticum.Associated with rheumatic fever, erythema marginatum rheumaticum causes erythematous lesions that are superficial, flat, and slightly hardened. They shift, spread rapidly, and may last for hours or days, recurring after a time.

Erythema multiforme.Erythema multiforme minor has typical urticarial red-pink iris-shaped localized lesions with little or no mucous membrane involvement. Most lesions occur on flexor surfaces of the extremities. Burning or itching may occur before or in conjunction with lesion development. Lesions appear in crops and last 2 or 3 weeks. After 1 week, individual lesions become flat or hyperpigmented. Early signs and symptoms may include a mild fever, cough, and sore throat.

Erythema multiforme major usually occurs as a drug reaction; has widespread symmetrical, bullous lesions that may become confluent; and includes erosions of the mucous membranes. Erythema is characteristically preceded by blisters on the lips, tongue, and buccal mucosa and a sore throat. Additional signs and symptoms that manifest early in the course of the disease include a cough, vomiting, diarrhea, coryza, and epistaxis. Later signs and symptoms include a fever, prostration, difficulty with oral intake due to mouth and lip lesions, conjunctivitis due to ulceration, vulvitis, and balanitis. The maximal variant of this disease is considered by many to be Stevens-Johnson syndrome, a multisystem disorder that can occasionally be fatal. In addition to all signs and symptoms mentioned above, the patient develops exfoliation of the skin from disruptions of bullae, although less than 10% of the body surface area is affected. These areas resemble second-degree thermal burns and should be cared for as such. Fever may rise to 102° F to 104° F (38.9° C to 40° C). The patient may also experience tachypnea; a weak, rapid pulse; chest pain; malaise; and muscle or joint pain.

Erythema nodosum.Sudden bilateral eruption of tender erythematous nodules characterizes erythema nodosum. These firm, round, protruding lesions usually appear in crops on the shins, knees, and ankles, but may occur on the buttocks, arms, calves, and trunk as well. Other effects include a mild fever, chills, malaise, muscle and joint pain and, possibly, swollen feet and ankles. Erythema nodosum is associated with various diseases, most notably inflammatory bowel disease, sarcoidosis, tuberculosis, and streptococcal and fungal infections.

Gout.Gout is characterized by tight and erythematous skin over an inflamed, edematous joint.

Kawasaki syndrome.This acute illness of unknown cause commonly produces a rash or erythema. No test is available for Kawasaki syndrome, which can cause serious heart damage and death if not detected and treated immediately. Additional characteristic signs include fever, conjunctival injection, and lymphadenopathy.

Lupus erythematosus.Discoid and systemic lupus erythematosus (SLE) can produce a characteristic butterfly rash. This erythematous eruption may range from a blush with swelling to a scaly, sharply demarcated, macular rash with plaques that may spread to the forehead, chin, ears, chest, and other sun-exposed parts of the body.

With discoid lupus erythematosus,telangiectasia, hyperpigmentation, ear and nose deformity, and mouth, tongue, and eyelid lesions may occur.

With SLE, an acute onset of erythema may also be accompanied by photosensitivity and mucous membrane ulcers, especially in the nose and mouth. Mottled erythema may occur on the hands, with edema around the nails and macular reddish purple lesions on the fingers. Telangiectasia occurs at the base of the nails or eyelids, along with purpura, petechiae, ecchymoses, and urticaria. Joint pain and stiffness are common. Other findings vary according to the body systems affected, but typically include a low-grade fever, malaise, weakness, a headache, arthralgia, arthritis, depression, lymphadenopathy, fatigue, weight loss, anorexia, nausea, vomiting, diarrhea, and constipation.

Psoriasis.Silvery white scales over a thickened erythematous base usually affect the elbows, knees, chest, scalp, and intergluteal folds. The fingernails may become thick and pitted.

Raynaud's disease.Typically, the skin on the hands and feet blanches and cools after exposure to cold and stress. Later, it becomes warm and purplish red.

Rosacea.Scattered erythema initially develops across the center of the face, followed by superficial telangiectases, papules, pustules, and nodules. Rhinophyma may occur on the lower half of the nose.

Rubella.Typically, flat solitary lesions join to form a blotchy pink erythematous rash that spreads rapidly to the trunk and extremities in this disorder. Occasionally, small red lesions (Forschheimer spots) occur on the soft palate. Lesions clear in 4 or 5 days. The rash usually follows a fever (up to 102° F [38.9° C]), a headache, malaise, a sore throat, a gritty eye sensation, lymphadenopathy, pain in the joints, and coryza.

Other causes

Drugs.Many drugs commonly cause erythema. (See Drugs associated with erythema, page 242.)

Radiation and other treatments.Radiation therapy may produce dull erythema and edema within 24 hours. As the erythema fades, the skin becomes light brown and mildly scaly. Any treatment that causes an allergic reaction can also cause erythema.

READ BOOK EXCERPT ONLINE »

Erythema multiforme as a symptom:

Conditions listing Erythema multiforme as a symptom may also be potential underlying causes of Erythema multiforme. Our database lists the following as having Erythema multiforme as a symptom of that condition:

• Coccidioidomycosis

Medications or substances causing Erythema multiforme:

The following drugs, medications, substances or toxins are some of the possible causes of Erythema multiforme as a symptom. This list is incomplete and various other drugs or substances may cause your symptoms. Always advise your doctor of any medications or treatments you are using, including prescription, over-the-counter, supplements, herbal or alternative treatments.

• Sulfatrim DS
• Sulfoxaprim
• Sulfoxaprim DS
• Trisulfam
• Uroplus DS

See full list of 30 medications causing Erythema multiforme

Medical news summaries relating to Erythema multiforme:

The following medical news items are relevant to causes of Erythema multiforme:

• Pfizer releases Bextra risks information

Related information on causes of Erythema multiforme:

As with all medical conditions, there may be many causal factors. Further relevant information on causes of Erythema multiforme may be found in:

• Risk factors for Erythema multiforme
• Medications that may cause Erythema multiforme
• Hidden causes of Erythema multiforme

Enter your search terms Submit search form
Search The Web Search wrongdiagnosis.com