Complications of Erythema Multiforme
The complications of erythema multiforme vary depending on the severity of the condition and whether mucous membranes are involved. Although erythema multiforme is often mild, serious cases can lead to discomfort, infection, or long-term effects—particularly when not managed properly.
Skin and Mucosal Damage
In more severe cases, the following complications may occur:
Secondary skin infections – Open sores can become infected, especially if scratched or not kept clean
Oral ulcers – May lead to difficulty eating, speaking, or swallowing
Eye involvement – Redness, irritation, or corneal ulcers that, if left untreated, can affect vision
Genital lesions – May cause pain, scarring, or discomfort during urination or sexual activity
Persistent symptoms require specialist attention to prevent long-term problems, especially in children or immunocompromised individuals.
Dehydration and Nutritional Deficiency
If the mouth or throat is affected, pain can make it difficult to eat or drink. This may lead to:
Dehydration
Weight loss
Nutritional imbalances
In such cases, intravenous fluids or nutritional supplements may be required to support recovery.
Recurrence
In people with herpes-triggered erythema multiforme, recurrence is a major issue. Episodes may return with every HSV outbreak, sometimes several times a year. Without antiviral suppression, this can greatly impact quality of life and cause emotional distress.
Long-term antivirals can significantly reduce recurrence rates, especially in patients with frequent flare-ups.
Psychological and Social Impact
Visible skin lesions, especially on the face or hands, may lead to:
Embarrassment or low self-esteem
Social withdrawal
School or work absenteeism
Fear of contagion, even though erythema multiforme is not infectious
Support and reassurance are important, especially in teenagers and young adults, to reduce anxiety and maintain self-confidence during flare-ups.
Complications of Erythema Multiforme In South Africa
In South Africa, HIV-positive patients may experience more frequent or severe complications from erythema multiforme. In these cases, immune suppression makes managing infections more difficult and healing slower. Co-treatment of underlying infections and immune support through ART is essential.
The complications of erythema multiforme are preventable with prompt, supportive care. By treating the cause and managing symptoms, most people recover fully and without lasting effects.
