Treatment of Erythema Multiforme
The treatment of erythema multiforme focuses on symptom relief, removing the trigger, and preventing recurrence. In most cases, erythema multiforme is self-limiting and clears up without scarring within two to four weeks. Severe or recurring cases require closer medical attention.
Mild Cases (Erythema Multiforme Minor)
For patients with limited skin involvement and no mucous membrane damage:
Antihistamines – Help reduce itching and discomfort
Topical corticosteroids – Ease inflammation on affected skin
Moisturisers – Protect the skin and promote healing
Pain relief – Paracetamol or ibuprofen can manage fever or soreness
Most cases resolve on their own once the trigger (usually a viral infection) passes.
Moderate to Severe Cases
If mucous membranes are involved (erythema multiforme major), or the rash is widespread, treatment may include:
Oral corticosteroids, such as prednisone, to reduce inflammation
Hospital admission, especially if eating or drinking is difficult
IV fluids, to prevent dehydration
Topical anaesthetic gels, for mouth or genital ulcers
Eye drops, if the eyes are involved
Severe oral involvement may require a soft diet, nutritional support, and careful oral hygiene.
Treating the Underlying Cause
Antiviral therapy, such as acyclovir or valacyclovir, is used in patients with HSV-triggered erythema multiforme
Antibiotics, if a bacterial infection like Mycoplasma pneumoniae is present
Drug discontinuation, if a new medication is the suspected cause
In recurrent HSV-related cases, long-term suppressive antiviral therapy may be prescribed to prevent future flare-ups.
Treatment of Erythema Multiforme In South Africa
In South Africa, access to antiviral medications and steroids is generally available in urban centres but more limited in remote clinics. Public sector stockouts and diagnostic uncertainty may delay treatment. Patient education about triggers, especially viral infections, is essential for early self-reporting and care.
The treatment of erythema multiforme is usually effective, particularly when started early. Preventing recurrence and managing discomfort are key goals.
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