How to Treat Erythema Multiforme?
Things to note:
Principles of management
- The foundation of management is supportive, good nursing, and dehydration and sepsis prevention.
- Stop all medicines.
- Patients usually require care in a high or intensive care unit with dedicated nursing.
- Monitor vital organ function.
- Examine daily for infection and swab infected lesions. If septicaemic, do blood cultures.
- Skin hygiene, daily cleansing and bland, non-adherent dressings as needed.
- Do not use silver sulfadiazine if condition is thought to be due to cotrimoxazole or other sulphonamide.
- Regular supervised oral, genital and eye care to prevent adhesions and scarring.
- Two-hourly mouth washes with bland mouth wash, e.g. glycothymol.
- Examine daily for ocular lesions and treat 2-hourly with eye care and lubricants and break down adhesions.
- Treat genitalia 6 hourly with Sitz baths and encourage movement of against eroded surfaces to prevent adhesions.
- Oral rehydration is preferred but intravenous fluid therapy may be required in significant dehydration.
- Encourage oral fluids to prevent pharyngeal adhesions.
- If unable to eat, provide soft, lukewarm food or nasogastric feeds.
- All the patients should wear a notification bracelet / necklace.
Medical Treatment:
Corticosteroids:
- There is no evidence to support the practice of using systemic corticosteroids and is therefore not recommended.
- Systemic antibiotics may be indicated, depending on results of appropriate cultures.
- Appropriate and adequate analgesia for the pain associated with dressing changes, given at least half an hour before dressing change.