Treatments for Erythema multiforme
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Hospital statistics for Erythema multiforme:
These medical statistics relate to hospitals, hospitalization and Erythema multiforme:
- 0.009% (1,210) of hospital consultant episodes were for erythema multiforme in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 87% of hospital consultant episodes for erythema multiforme required hospital admission in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 51% of hospital consultant episodes for erythema multiforme were for men in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 49% of hospital consultant episodes for erythema multiforme were for women in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
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Oral Lesions:
Treatment
(In a Page: Signs and Symptoms)
-
Orabase® compounded with high-potency topical steroids (e.g., clobetasol) may offer symptomatic relief and increase speed of healing
-
“Magic mouthwash” may be used to swish and spit as necessary for relief (these may contain lidocaine, diphenhydramine, antacids, and even liquid tetracycline)
-
Aphthous stomatitis: Intralesional triamcinalone injections
are painful but very helpful
–Lesions spontaneously resolve within 2 weeks
- Recurrent herpes stomatitis: Episodic treatment with 1–7 day courses of oral antivirals (e.g., acyclovir) can shorten the duration of the episode and speed healing
–These are efficacious only if started within 24 hours of the onset of the prodrome (often tingling or pain at the site of eruption occurs hours before onset)
–Chronic suppressive therapy with oral antivirals may be indicated if recurrences are frequent
- Bullous diseases: Corticosteroids (topical or oral), cyclosporine, and even thalidomide
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Stomatitis:
Treatment
(In a Page: Signs and Symptoms)
Aphthous stomatitis: Symptomatic treatment only; lesions
spontaneously resolve within 2 weeks
–Strict oral hygiene (e.g., antiseptic mouthwash)
–Topical anesthetics may relieve pain
–Judicious use of topical and oral steroids in severe
disease
–Oral thalidomide reportedly helpful in severe disease (e.g., AIDS patients) Infectious stomatitis: Target specific organism with
appropriate antimicrobial treatment
–Topical antiseptic/anesthetic
–Coating agents (e.g., milk of magnesia, aluminum
hydroxide) may be helpful
-
Gangrenous stomatitis
–High-dose IV penicillin
–Correct underlying malnutrition or debility
–Surgery may be necessary
-
Chronic granulomatous disease: Early recognition and aggressive management of infections
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Stomatitis:
Treatment
(In A Page: Pediatric Signs and Symptoms)
-
Symptomatic care
–Rinsing with a 1:1 solution of dipheniramine with
antacid provides temporary relief
–Acetaminophen may be used liberally
-
Occlusive topical solutions may aid in healing
- Topical anesthetics such as benzocaine or viscous lidocaine should be used sparingly if at all in children
–Damage to the mucous membranes may result
–Accidental swallowing can lead to aspiration
secondary to the impairment of the gag reflex
-
For severe or recurrent aphthous ulcers, systemic steroids or colchicine are sometimes used
-
-
-
Herpetic lesions are treated with oral acyclovir
-
Trench mouth is treated with penicillin
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Stomatitis and other oral infections:
Treatment
(Professional Guide to Diseases (Eighth Edition))
For acute herpetic stomatitis, treatment is conservative. For local symptoms, supportive measures include warm salt-water mouth rinses (antiseptic mouthwashes are contraindicated because they are irritating) and a topical anesthetic to relieve mouth ulcer pain. Topical antihistamines, antacids, or corticosteroids may also be recommended. Supplementary treatment includes a bland or liquid diet and, in severe cases, I.V. fluids and bed rest.
For aphthous stomatitis, primary treatment is application of a topical anesthetic. Effective long-term treatment requires alleviation or prevention of precipitating factors.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Toxic epidermal necrolysis:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Treatment consists of transferring the patient to a burn center or an intensive care unit and providing I.V. fluid replacement to maintain fluid and electrolyte balance. Xenografts should be used to prevent pain and infection and to provide the framework for reepithelialization. High doses of I.V. immunoglobulins may halt progression if given early in the course of illness. Steroids may be appropriate initially, but should be discontinued as soon as healing occurs. Use of steroids may decrease survival rates only secondary to increased incidence of infections and other complications. Necrotic skin should be débrided. The patient also should stop using suspected drugs.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Staphylococcal scalded skin syndrome:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Treatment includes systemic antibiotics, usually penicillinase-resistant penicillin. Severe cases require hospitalization and I.V. antibiotics. Oral antibiotics should be adequate for milder cases. Skin lubrication with a non–alcohol-based preparation is beneficial. Washing or bathing should be done sparingly. Replacement measures to maintain fluid and electrolyte balance are necessary.
PEDIATRIC TIP Admission is appropriate for neonates and young children with extensive sloughing.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Erythema [Erythroderma]:
Emergency interventions
(Professional Guide to Signs & Symptoms (Fifth Edition))
If your patient suddenly develops progressive erythema with a rapid pulse, dyspnea, hoarseness, and agitation, quickly take his vital signs. These may be indications of anaphylactic shock. Provide emergency respiratory support and give epinephrine.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Stomatitis and other oral infections:
Treatment
(Handbook of Diseases)
For acute herpetic stomatitis, treatment is conservative. For local symptoms, management includes warm-water mouth rinses (antiseptic mouthwashes are contraindicated because they’re irritating) and a topical anesthetic to relieve mouth ulcer pain.
CLINICAL TIP: A course of acyclovir (200 to 800 mg, five times daily for 7 to 14 days) may shorten the course and reduce postherpetic pain.
Supplementary treatment includes bland or liquid diet and, in severe cases, I.V. fluids to maintain hydration, and bed rest. After the gums are less tender, a dentist should scale and polish the teeth and emphasize good oral hygiene.
For aphthous stomatitis, primary treatment is application of a topical anesthetic. Effective long-term treatment requires alleviation or prevention of precipitating factors.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Staphylococcal scalded skin syndrome:
Treatment
(Handbook of Diseases)
Systemic antibiotics treat the underlying infection. Replacement measures maintain fluid and electrolyte balance to prevent dehydration. Moist compresses may improve comfort, and an emollient may help keep skin moist.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Erythema:
Nursing considerations
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
Because erythema can cause fluid loss, closely monitor and replace fluids and electrolytes, especially in patients with burns or widespread erythema. Be sure to withhold all medications until the cause of the erythema has been identified. Then expect to administer an antibiotic and a topical or systemic corticosteroid.
For the patient with itching skin, expect to give soothing baths or apply open wet dressings containing starch, bran, or sodium bicarbonate; also administer an antihistamine and an analgesic as needed. Advise a patient with leg erythema to keep his legs elevated above heart level. For a burn patient with erythema, immerse the affected area in cold water, or apply a sheet soaked in cold water to reduce pain, edema, and erythema.
Prepare the patient for diagnostic tests, such as skin biopsy to detect cancerous lesions, cultures to identify infectious organisms, and sensitivity studies to confirm allergies.
Patient teaching
Teach the patient with a chronic disease, such as SLE or psoriasis, about the character of typical rashes so they can be alert to any flare-ups of the disease. Also, advise the patient to avoid sun exposure and to use sunblock when appropriate. Discuss measures to relieve itching.
» READ BOOK EXCERPT ONLINE »
Source: Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series, 2007
Erythema:
Emergency Actions
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
If your patient has sudden progressive erythema with rapid pulse, dyspnea, hoarseness, and agitation, quickly take his vital signs. These may be indications of anaphylactic shock. Provide emergency respiratory support and give epinephrine.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Erythema [Erythroderma]:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Monitor and replace fluids and electrolytes, especially in patients with burns or widespread erythema.
▪ Withhold all medications until the cause of the erythema has been identified.
▪ Administer an antibiotic and a topical or systemic corticosteroid as ordered.
▪ For the patient with itching skin, give soothing baths or apply open wet dressings containing starch, bran, or sodium bicarbonate.
▪ Administer an antihistamine and analgesic as needed.
▪ For a burn patient with erythema, immerse the affected area in cold water, or apply a sheet soaked in cold water to reduce pain, edema, and erythema.
▪ Prepare the patient for diagnostic tests, such as skin biopsy to detect cancerous lesions, cultures to identify infectious organisms, and sensitivity studies to confirm allergies.
▪ Have the patient with leg erythema keep his legs elevated above heart level.
Patient teaching
▪ Stress the avoidance of sun exposure and use of sunblock.
▪ Teach the patient methods to relieve itching.
▪ Explain the underlying cause of the patient's erythema and its treatment.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
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