Erythema Multiforme Management

Immediate Management Priorities

• The British Journal of Dermatology recommends discontinuing any suspected culprit medications immediately if drug-induced EM is suspected, and documenting all medications taken in the previous 2 months, including over-the-counter and complementary therapies 1
• The British Journal of Dermatology suggests examining all mucosal sites for involvement and documenting the extent of skin involvement and presence of target lesions 1
• The British Journal of Dermatology advises applying emollients and skin moisturizers to affected areas 1

Treatment Algorithm by Severity

• The Annals of Oncology recommends using topical corticosteroids (e.g., hydrocortisone cream) for symptomatic relief of skin lesions 2

Monitoring and Follow-Up

• The British Journal of Dermatology and the Annals of Oncology recommend reassessing after 2 weeks of treatment; if worsening or no improvement, escalate therapy 1, 2

Treatment of Erythema Multiforme

Patient Counseling and Disease Course

• The American Academy of Dermatology recommends avoiding ice water immersion and continuous fan use, despite the temptation to cool affected areas, as these can cause tissue damage, ulcerations, and paradoxical worsening of symptoms, and limit cooling measures to 10 minutes, 4 times daily maximum, as suggested by the Mayo Clinic Proceedings 3

Disease Characteristics

• Individual lesions in erythema multiforme persist for at least 7 days, distinguishing it from urticaria where lesions resolve within 24 hours, although the exact duration may vary depending on the severity of the condition and the presence of underlying triggers 3