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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



Last reviewed 03/2021