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American Family Physician Jul 2019Erythema multiforme is an immune-mediated reaction that involves the skin and sometimes the mucosa. Classically described as target-like, the erythema multiforme lesions... (Review)
Review
Erythema multiforme is an immune-mediated reaction that involves the skin and sometimes the mucosa. Classically described as target-like, the erythema multiforme lesions can be isolated, recurrent, or persistent. Most commonly, the lesions of erythema multiforme present symmetrically on the extremities (especially on extensor surfaces) and spread centripetally. Infections, especially herpes simplex virus and Mycoplasma pneumoniae, and medications constitute most of the causes of erythema multiforme; immunizations and autoimmune diseases have also been linked to erythema multiforme. Erythema multiforme can be differentiated from urticaria by the duration of individual lesions. Erythema multiforme lesions are typically fixed for a minimum of seven days, whereas individual urticarial lesions often resolve within one day. Erythema multiforme can be confused with the more serious condition, Stevens-Johnson syndrome; however, Stevens-Johnson syndrome usually contains widespread erythematous or purpuric macules with blisters. The management of erythema multiforme involves symptomatic treatment with topical steroids or antihistamines and treating the underlying etiology, if known. Recurrent erythema multiforme associated with the herpes simplex virus should be treated with prophylactic antiviral therapy. Severe mucosal erythema multiforme can require hospitalization for intravenous fluids and repletion of electrolytes.
Topics: Erythema Multiforme; Humans
PubMed: 31305041
DOI: No ID Found -
Journal of Cosmetic Dermatology Apr 2022Post-acne erythema (PAE) is a common sequela of acne inflammation, and it refers to telangiectasia and erythematous lesions remaining after the acne treatment. Although... (Review)
Review
Post-acne erythema (PAE) is a common sequela of acne inflammation, and it refers to telangiectasia and erythematous lesions remaining after the acne treatment. Although some PAE lesions may improve over time, persisting PAE might be esthetically undesirable for patients. The efficacy of various treatment options for PAE has been investigated in many studies but there exists no gold standard treatment modality. In this study, we aimed to give a systematic literature review on various treatment options for PAE, the advantage of each modality, and compare their efficacy, safety, and feasibility. By using the selected keywords, we carried out a systematic search for articles published from the inception to 28 April 2021 in PubMed/Medline and Embase databases. Of the 5796 initially retrieved articles, 18 of them were fully eligible to be enrolled in our study. In this study, we found that light and laser-based devices were the most frequently used treatments for PAE. Generally, pulsed-dye lasers were the most commonly used laser devices for PAE. Neodymium:yttrium aluminum-garnet lasers were the second most commonly used modalities in treating PAE. Topical treatments such as oxymetazoline, tranexamic acid, and brimonidine tartrate are promising treatments in reducing PAE lesions. In our study, no severe side effects were found. In conclusion, both laser devices and topical agents seem to be effective for PAE lesions; however, further randomized clinical trials are needed in this field.
Topics: Acne Vulgaris; Brimonidine Tartrate; Erythema; Humans; Lasers, Dye; Lasers, Solid-State; Treatment Outcome
PubMed: 35076997
DOI: 10.1111/jocd.14804 -
American Family Physician Sep 2018Annular lesions can present in a variety of diseases. Knowledge of the physical appearance and history of presentation of these skin findings can help in the diagnosis.... (Review)
Review
Annular lesions can present in a variety of diseases. Knowledge of the physical appearance and history of presentation of these skin findings can help in the diagnosis. A pruritic, annular, erythematous patch that grows centrifugally should prompt evaluation for tinea corporis. Tinea corporis may be diagnosed through potassium hydroxide examination of scrapings. Recognizing erythema migrans is important in making the diagnosis of Lyme disease so that antibiotics can be initiated promptly. Plaque psoriasis generally presents with sharply demarcated, erythematous silver plaques. Erythema multiforme, which is due to a hypersensitivity reaction, presents with annular, raised lesions with central clearing. Lichen planus characteristically appears as planar, purple, polygonal, pruritic papules and plaques. Nummular eczema presents as a rash composed of coin-shaped papulovesicular erythematous lesions. Treatment is aimed at reducing skin dryness. Pityriasis rosea presents with multiple erythematous lesions with raised, scaly borders, and is generally self-limited. Urticaria results from the release of histamines and appears as well-circumscribed, erythematous lesions with raised borders and blanched centers. Annular lesions occur less commonly in persons with fixed drug eruptions, leprosy, immunoglobulin A vasculitis, secondary syphilis, sarcoidosis, subacute cutaneous lupus erythematosus, and granuloma annulare.
Topics: Diagnosis, Differential; Erythema; Humans; Patient Care Management; Skin Diseases; Skin Diseases, Genetic
PubMed: 30216021
DOI: No ID Found -
Journal of the American Academy of... Sep 2022The genital skin may be affected by a variety of dermatoses, be it inflammatory, infectious, malignant, idiopathic, or others. The red scrotum syndrome is characterized... (Review)
Review
The genital skin may be affected by a variety of dermatoses, be it inflammatory, infectious, malignant, idiopathic, or others. The red scrotum syndrome is characterized by persistent erythema of the scrotum associated with a burning sensation, hyperalgesia, and itching. Its cause is unknown, but proposed mechanisms include rebound vasodilation after prolonged topical corticosteroid use and localized erythromelalgia. The condition is chronic, and treatment is often difficult. Here we review the etiology, the physical and histopathologic findings, and the management of this condition. We also describe related conditions such as red scalp syndrome, red ear syndrome, and red vulva syndrome. Finally, we summarize the different cases reported in the literature and discuss the features that help in the differentiation of red scrotum syndrome from its mimickers.
Topics: Erythema; Erythromelalgia; Female; Humans; Male; Scrotum; Skin; Syndrome
PubMed: 32497688
DOI: 10.1016/j.jaad.2020.05.113 -
Journal Der Deutschen Dermatologischen... Jun 2020Prior to the first international consensus classification published in 1993, the clinical distinction between erythema multiforme (EM), Stevens-Johnson syndrome (SJS)... (Review)
Review
Prior to the first international consensus classification published in 1993, the clinical distinction between erythema multiforme (EM), Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) had been subject to uncertainty and controversy for more than a century. Based on this classification, the three conditions are defined by the morphology of the individual lesions and their pattern of distribution. Etiopathogenetically, the majority of EM cases is caused by infections (primarily herpes simplex virus and Mycoplasma pneumoniae), whereas SJS/TEN are predominantly triggered by drugs. The SCORTEN (score of toxic epidermal necrolysis) can and should be used to assess disease prognosis in patients with SJS/TEN. While supportive treatment is generally considered sufficient for EM, there is still uncertainty as to the type of systemic therapy required for SJS/TEN. Given the lack of high-quality therapeutic trials and (in some cases) conflicting results, it is currently impossible to issue definitive recommendations for any given immunomodulatory therapy. While there is always a trade-off between rapid onset of treatment-induced immunosuppression and an uptick in infection risk, there has been increasing evidence that cyclosporine in particular may be able to halt disease progression (i.e. skin detachment) and lower mortality rates. Assistance in diagnosis and management of the aforementioned conditions may be obtained from the Center for the Documentation of Severe Skin Reactions (dZh) at the Department of Dermatology, University Medical Center, Freiburg, Germany.
Topics: Erythema Multiforme; Germany; Humans; Stevens-Johnson Syndrome
PubMed: 32469468
DOI: 10.1111/ddg.14118 -
Journal of the American Academy of... Jun 2023Patients with refractory erythema of rosacea have limited treatment options. (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Patients with refractory erythema of rosacea have limited treatment options.
OBJECTIVE
To evaluate the efficacy and safety of a 12-week course of paroxetine for moderate-to-severe erythema of rosacea.
METHODS
In a multicenter, randomized, double-blinded, placebo-controlled trial, patients with refractory erythema of rosacea were randomly assigned (1:1) to receive paroxetine 25 mg daily or placebo for 12 weeks.
RESULTS
Overall, 97 patients completed the study (paroxetine: 49; placebo: 48). The primary end point was the proportion of participants achieving Clinical Erythema Assessment success (defined as Clinical Erythema Assessment score of 0, 1, or ≥2-grade improvement from baseline) at week 12; this was significantly greater in the paroxetine group than in the placebo group (42.9% vs 20.8%, P = .02). Some secondary end points were met, such as flushing success with point reductions ≥2 (44.9% vs 25.0%, P = .04) and improvement in overall flushing (2.49 ± 3.03 vs 1.68 ± 2.27, P = .047), burning sensation (46.9% vs 18.8%, P = .003), and depression (P = .041). The most reported adverse events associated with paroxetine were dizziness, lethargy, nausea, dyspepsia, and muscle tremors.
LIMITATIONS
Only a single-dosage regimen of paroxetine within a 12-week study was evaluated.
CONCLUSIONS
Paroxetine is an effective and well-tolerated alternative treatment for moderate-to-severe erythema of rosacea.
Topics: Humans; Paroxetine; Prospective Studies; Rosacea; Erythema; Treatment Outcome; Double-Blind Method
PubMed: 36806645
DOI: 10.1016/j.jaad.2023.01.044 -
Clinics in Dermatology 2017Facial erythema (the "red face") is a straightforward clinical finding, and it is evident even to the untrained eye; however, a red face does not represent a single... (Review)
Review
Facial erythema (the "red face") is a straightforward clinical finding, and it is evident even to the untrained eye; however, a red face does not represent a single cutaneous entity. It may be due to a plethora of distinct underlying conditions of varying severity, including rosacea, demodicosis, dermatomyositis, lupus erythematosus, allergic contact dermatitis, drug-induced erythema, and emotional blushing. In clinical practice, dermatologists do not encounter only one type of facial erythema but rather a number of different shades of red. This review presents the clinical spectrum of facial erythemas and addresses the question of what lies beneath a red face by discussing the key clinical and histopathologic characteristics.
Topics: Dermatomyositis; Diagnosis, Differential; Erythema; Facial Dermatoses; Humans; Lupus Erythematosus, Systemic; Rosacea
PubMed: 28274360
DOI: 10.1016/j.clindermatol.2016.10.015 -
Clinics in Dermatology 2021Skin erythema may present owing to many causes. One of the common causes is prolonged exposure to sunrays. Other than sun exposure, skin erythema is an accompanying sign... (Review)
Review
Skin erythema may present owing to many causes. One of the common causes is prolonged exposure to sunrays. Other than sun exposure, skin erythema is an accompanying sign of dermatologic diseases, such as psoriasis and acne. Quantifying skin erythema in patients enables the dermatologist to assess the patient's skin health. Quantitative assessment of skin erythema has been the focus of several studies. The clinical standard for erythema evaluation is visual assessment; however, this standard has some deficiencies. For instance, visual assessment is subjective and ineffectual for precise color information exchange. To overcome these limitations, in the past three decades various methodologies have been developed in an attempt to achieve objective erythema assessments, such as diffuse reflectance spectroscopy and both optical and nonoptical systems. This review considers the studies published during the past three decades and discusses the performance, the mathematical tactics for computation, and the limited capabilities of erythema assessment techniques for cutaneous diseases. The achievements and limitations of the current techniques in erythema assessment are presented. The advantages and development trends of optical and nonoptical methods are presented to make the reader aware of the present technological advances and their potential for dermatological disease research.
Topics: Erythema; Humans; Psoriasis; Skin; Skin Pigmentation
PubMed: 34809765
DOI: 10.1016/j.clindermatol.2021.03.006 -
Medicina Clinica Jan 2021
Topics: Erythema; Erythema Chronicum Migrans; Humans; Lyme Disease
PubMed: 31780214
DOI: 10.1016/j.medcli.2019.10.001 -
Cutis Apr 2023Erythema ab igne (EAI) is a skin condition caused by chronic heat-induced damage. The rash usually progresses over weeks to months of repeated or prolonged exposure to... (Review)
Review
Erythema ab igne (EAI) is a skin condition caused by chronic heat-induced damage. The rash usually progresses over weeks to months of repeated or prolonged exposure to subthreshold-intensity infrared radiation that is not hot enough to cause a burn. The diagnosis is clinical based on patient history and physical examination, but a biopsy can reveal dilated vasculature, interface dermatitis, and pigment incontinence. Erythema ab igne initially was described in association with patients cooking over wood-fire stoves but has been shown over the decades to have a variety of causes. Herein, we describe various etiologies of EAI, including new heat-producing technologies, cultural practices, psychiatric illnesses, and even iatrogenic causes. However, the cause most commonly is application of heat for treatment of chronic pain, which may be a diagnostic clue for an underlying chronic illness. Although there are no current US Food and Drug Administration-approved therapies for treatment of EAI hyperpigmentation, the prognosis is excellent because removal of the heat source often will result in spontaneous resolution over time. Finally, chronic EAI rarely has been reported to evolve into squamous cell carcinoma, poorly differentiated carcinoma, cutaneous marginal zone lymphoma, and even Merkel cell carcinoma.
Topics: Humans; Erythema; Erythema Ab Igne; Skin; Hyperpigmentation; Skin Neoplasms; Hot Temperature
PubMed: 37289686
DOI: 10.12788/cutis.0771