exudative erythema multifo
exudative erythema multiforme (Stevens - Jones) - an acute disease of the skin and mucous membranes of the mouth, which is characterized by papular, cystic and spotty rash.In most cases, in children and middle-aged people (usually male).Exudative erythema multiforme develop after infection of the upper respiratory tract;as an allergic reaction to certain types of infections, drugs and autotoksicheskie substance.There have been documented cases of this disease after being poisoned with gasoline, and which developed as a result of intoxication due to snake bites.
distinctive feature of exudative erythema multiforme are erythematous papular skin formation increases towards the periphery, with vesicles in the center.These skin rashes can spread to a large enough surface of the body (including the palms and soles), but the scalp is not affected.In about 15% of patients only defeat of the oral mucosa.According to its clinical manifestations, exudative erythema multiforme oral mucosa more monomorphic than on the skin, however, is much harder on subjective sensations and its flow.This process can be both localized and widespread, capturing almost the entire oral mucosa
In most cases, the appearance of skin rash preceded by malaise and fever (body temperature rises to 38 - 39 * C), there headaches , as well as joint and muscle pain.The initial manifestations of the disease on the oral mucosa are erythema and edema, against which there are subepithelial bubbles, different in size and location, with serous content and greyish - white dense cover.Salivation amplified pain occur when eating.After one - two days, the bubbles burst, forming a fairly extensive painful erosions covered with yellowish fibrinous raid that bleed when you try to remove it.
defeat of the corners of the mouth and red border is often accompanied by swelling.Cystic lesions on the lips opened quickly enough after their appearance, and covered with coarse erosion bloody crusts that are due to the accession of secondary infection become dirty - gray.From - due to significant morbidity data rashes in patients with difficult swallowing and speech, they can not open his mouth properly.Such symptoms were saved from a half to three weeks
For successful treatment of exudative erythema multiforme requires the elimination of foci of infection, readjustment of the body, in the case of medicinal natural occurrence - excretion of the drug that caused the disease.
During the first two - three days of bed rest is shown.Intravenous administration shows 10 ml of 10% solution of calcium chloride;tableted appoint 1 g 4 times daily sodium salicylate, antihistamines (Phencarolum, tavegil, suprastin, diphenhydramine).In more severe cases, it is shown receiving broad-spectrum antibiotics and corticosteroids, intravenous drip - gemodez, reopoligljukin and so on. It is mandatory appointed complex vitamins (PP, C and B).
Local treatment is directed to the acceleration of epithelialization of erosions, as well as the elimination of edema and inflammatory foci.On the eroded surface applications used analgesic solutions and solutions of enzymes (chymotrypsin, trypsin), weak antiseptic solutions is carried out irrigation of the mouth;the mucous membrane of the mouth and lips of the applicator are applied ointment containing affecting skin products (sea buckthorn, wild rose, karotolin) and corticosteroids.Local treatment should be carried out every three hours.