32
Erythema
Erythema is a skin condition characterized by redness or rash . There are many types , including photosensitivity , erythema multiforme , and erythema nodosum .
What Causes It ?
Photosensitivity is caused by a reaction to sunlight and tends to occur when something , such as an infection or a medication , increases your sensitivity to ultraviolet radiation . Erythema multiforme is characterized by raised spots or other lesions on the skin . It is usually caused by a reaction to medications , infections ( especially herpes simplex virus ), or illness . Erythema nodosum is a form of erythema that ’ s accompanied by tender lumps , usually on the legs below the knees , and may be caused by certain medications or diseases .
In half of all cases of either erythema multiforme or erythema nodosum , the exact cause is not known . In other cases , a variety of causes may result in erythema .
Erythema multiforme :
• Infection , primarily from the herpes simplex virus ( HSV )
• Medications , such as penicillin and sulfa drugs ; antiseizure medications ; nonsteroidal anti-inflammatory drugs ( NSAIDs )
Erythema nodosum :
• Infections , including mononucleosis
• Connective tissue disorders , such as lupus
• Pregnancy
• Ulcerative colitis
• Bechet disease
• Crohn disease
• Medications , such as birth control pills ; sulfa drugs
Who is Most at Risk ?
Men are at greater risk than women for erythema multiforme , while women are at greater risk than men for erythema nodosum . Frequent or excessive sun exposure increases the risk for erythema multiforme . People aged between 20 to 30 years of age are at greater risk of
COLLIN COUNTY Living Well Magazine | SEPTEMBER / OCTOBER 2017
erythema nodosum , while people with a family history of skin conditions have a greater chance of developing either erythema multiforme or erythema nodosum . If a pregnant woman develops erythema infectiosum ( fifth disease ), the virus can infect the fetus and cause fetal anemia , heart failure , hydrops , and even death .
Signs and Symptoms
Erythema multiforme :
• Fatigue , fever , and itching ( before lesions appear )
• Sudden outbreak of spots , bumps , and lesions ( usually on knees , elbows , palms , hands , and feet )
• Target lesions ( spots surrounded by rings of normal and red skin , looking like a target )
• Erythema infectiosum ( caused by a virus and known as fifth disease ), rash on face and arms lasting about two weeks
Erythema nodosum :
• Fatigue , flu-like symptoms ( before lesions appear )
• Clusters of nodules ( small round masses ) and lesions on shins , forearms , thighs , and trunk
• Red , painful lesions become soft and bluish , and fade to yellow and brown
• Joint pain
• Arthritis
Stevens-Johnson syndrome ( SJS ) and toxic epidermal necrolysis ( TEN ), the most severe forms of erythema multiforme , have a different set of symptoms . Target lesions on the trunk , hacking cough , fever , and blisters around the mouth , eyes , nostrils , and anal and vaginal areas are the key symptoms of SJS . A person with TEN will have symptoms of SJS that worsen to include peeling and detachment of the skin , pus-like infections , fluid loss , and even death .
Treatment Options
Your doctor will perform a physical exam and may order a skin biopsy , throat culture , blood test , or x-ray to determine the type of erythema . These tests also may reveal any infections or medications that are contributing to symptoms .
By Dr . Donna Barsky , PharmD
Your doctor will treat any underlying diseases , stop any drugs that may contribute to symptoms , and take steps to control your current symptoms . Mild cases may not require treatment . Bed rest and medication may be necessary for more severe cases .
Drug Therapies
• Antihistamines for itching
• Antibiotics . If you have an infection , though research suggests many cases of erythema can be resolved without antibiotics
• Antiviral medications such as acyclovir and valacyclovir , if you have a virus
• Aspirin and nonsteroidal anti-inflammatory drugs ( NSAIDs )
• Burrow › s compresses , a solution used to soothe skin conditions , particularly blisters
• Corticosteroids , applied to the skin ( topically ); corticosteroids may also be taken orally to reduce symptoms of erythema nodosum
• Intravenous immunoglobulin , used experimentally for SJS and TEN
• Photomodulation therapy , use of a light-emitting diode to accelerate the resolution of erythema
Complementary and Alternative Therapies
To treat erythema , you must treat the underlying cause . It is important to get a proper diagnosis from your doctor before using complementary and alternative therapies ( CAM ). Not all CAM therapies are appropriate for all people , and some may interact with conventional medicines or therapies . You should use CAM therapies only under the guidance of a physician . Some CAM therapies may be used to reduce inflammation , boost the immune system and prevent infections .
Nutrition
Antioxidants are molecules that scavenge free radicals ( chemicals that can damage cells ). Antioxidants also may protect skin against damage caused by ultraviolet ( UV ) sun rays . The following antioxidants have been shown to protect skin against damage in scientific studies . Because some of these