Treatment depends on the underlying cause. Initial management includes treatment of the suspected infectious disease or to discontinue the causal drug (1).
Some general principles are outlined below:
- secondary infection and dehydration should be prevented - especially if the patient has Stevens-Johnson syndrome or toxic epidermal necrolysis
- itch may be a prominent feature - a combination of a potent topical steroid and an antihistamine may help to relieve this (2)
- oral acyclovir for patients with coexisting or recent HSV infection to reduce the number and duration of cutaneous lesions (1).
- the condition may take up to three weeks to resolve (2)
- recurrent episodes of erythema multiforme are often due to herpes simplex an may respond to long-term treatment with aciclovir. These patients should also be referred to a dermatologist for further treatment (1)
- the role of oral steroids is controversial in this condition
- (1) Lamoreux MR et al. Erythema Multiforme. AFP 2006;74(11)
- (2) The Practitioner (2001), 345, 937-41
Last reviewed 03/2021