Erythema is a skin condition characterized by redness or rash. There are many types of erythema, including photosensitivity, erythema multiforme, and erythema nodusum. Photosensitivity is caused by a reaction to sunlight and tends to occur when something, such as an infection or a medication, increases your sensitivity to ultraviolet radiation. Erythema multiforme is characterized by raised spots or other lesions on the skin. It is usually caused by a reaction to medications, infections (especially herpes simplex virus), or illness. Erythema nodosum is a form of erythema that is accompanied by tender lumps, usually on the legs below the knees, and may be caused by certain medications or diseases.
What Causes It?
In half of all cases of either erythema multiforme or erythema nodosum, the exact cause is not known. In other cases, a variety of causes may result in erythema.
Who's Most At Risk?
Signs and Symptoms
Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), the most severe forms of erythema multiforme, have a different set of symptoms. Target lesions on the trunk, hacking cough, fever, and blisters around the mouth, eyes, nostrils, and anal and vaginal areas are the key symptoms of SJS. A person with TEN will have symptoms of SJS that worsen to include peeling and detachment of the skin, pus-like infections, fluid loss, and even death.
What to Expect at Your Provider's Office
Your doctor will perform a physical exam and may order a skin biopsy, throat culture, blood test, or x-ray to determine the type of erythema. These tests also may reveal any infections or medications that are contributing to symptoms.
Treat underlying diseases and avoid known triggers (certain medications, for example). It is also important to avoid the sun when taking certain medications.
Your doctor will treat any underlying diseases, stop any drugs that may contribute to symptoms, and take steps to control your current symptoms. Mild cases may not require treatment. Bed rest and medication may be necessary for more severe cases.
Complementary and Alternative Therapies
To treat erythema, you must treat the underlying cause. It is important to get a proper diagnosis from your doctor before using complementary and alternative therapies. Not all CAM therapies are appropriate for all people, and some may interact with conventional medicines or therapies. You should use CAM therapies only under the guidance of a physician. Some CAM therapies may be used to:
Antioxidants are molecules that scavenge free radicals (chemicals that can damage cells). Antioxidants also may protect skin against damage caused by ultraviolet (UV) sun rays. The following antioxidants have been shown to protect skin against damage in scientific studies:
Flavonoids -- Some of these plant-based antioxidants may protect skin from sun damage in healthy people. In one study, German researchers found that drinking high flavonol cocoa offered protection from the sun (the cocoa used was a special formulation that is not available commercially). In another study, pomegranate fruit extract helped protect skin cells in a test tube from UV light. It isn't yet known whether taking the extract would provide any benefit. However, adding fruits and vegetables to your diet to eat more flavonoids may help. You can also take these flavonoids in dried extract form. Speak with your physician first, since certain flavonoids can interact with prescription medications:
Green tea (Camellia sinensis) may also protect against erythema caused by UV light because it contains antioxidants.
Herbs traditionally used topically to heal damaged skin, promote lymph circulation, and possibly treat the underlying cause of various skin conditions may be helpful. You should check with your doctor before using any of these remedies. Some examples include:
Although few studies have examined the effectiveness of specific homeopathic therapies, professional homeopaths may consider the following remedies for the treatment of erythema based on their knowledge and experience. Before prescribing a remedy, homeopaths take into account a person's constitutional type -- your physical, emotional, and psychological makeup. An experienced homeopath assesses all of these factors when determining the most appropriate treatment for an individual.
When treated properly, signs and symptoms of erythema multiforme usually disappear within 4 - 6 weeks. Symptoms of erythema nodosum, however, may reappear for up to 2 years. Symptoms of SJS typically disappear in a month, but when the condition is not treated properly it may lead to blindness. Both SJS and TEN can cause death. If the drug causing either SJS or TEN is identified quickly, a person's chance of survival significantly improves.
Your doctor will monitor fluid and electrolyte levels, protein loss, and any organ damage. Persons with erythema multiforme may need treatment in a hospital burn unit if 20% or more of their body is affected.
If a pregnant woman develops erythema infectiosum (fifth disease), the virus can infect the fetus and cause fetal anemia, heart failure, hydrops (collection of watery fluid), and even death. Studies have also shown that pregnancy may trigger erythema nodosum.
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Review Date: 2/21/2013
Reviewed By: Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.
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