Symptoms of Erythema Multiforme
The symptoms of erythema multiforme often appear suddenly and include a range of skin and mucous membrane changes. Erythema multiforme typically starts with general discomfort or mild flu-like symptoms, followed by the appearance of distinctive skin lesions within 24 to 48 hours.
Skin Symptoms
Target lesions – The hallmark of the condition. These are round spots with three zones: a dark or blistered centre, a pale ring, and a bright red outer ring.
Symmetrical rash – Lesions usually appear on both sides of the body, starting on the backs of hands and feet before spreading to arms, legs, and face.
Itching or burning – Affected areas may feel irritated.
New lesions – May continue to appear for up to a week.
Crusting or peeling – In later stages, lesions may scab over or flake off.
In mild cases, the rash is limited to the skin and resolves without scarring.
Mucous Membrane Involvement
In erythema multiforme major, mucous membranes may be affected, especially in the:
Mouth – Painful ulcers or blisters that make eating or drinking difficult
Eyes – Redness, discharge, or discomfort
Genital area – Painful sores or inflammation
Involvement of these areas can lead to severe discomfort and requires medical attention. In rare cases, conjunctivitis or corneal ulcers may develop, risking vision if untreated.
Systemic Symptoms
Before or during a flare-up, some people experience:
Low-grade fever
Fatigue
Joint pain
Headache
General body aches
These symptoms are more common in major cases and usually resolve as the rash improves.
Symptoms of Erythema Multiforme In South Africa
In South Africa, individuals with HIV may present with more frequent or severe episodes of erythema multiforme due to immune system dysregulation. Co-infections such as herpes simplex virus may also complicate the presentation.
Clinics and hospitals should be prepared to treat both the skin condition and any underlying infection. Misidentifying erythema multiforme as another rash—such as measles, allergic reaction, or even Stevens-Johnson syndrome—can delay care.
Identifying the symptoms of erythema multiforme early ensures faster treatment and avoids progression to more serious complications.
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