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Guilherme Mazui

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What is the Difference Between Erythema Multiforme and Stevens Johnson Syndrome?

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Erythema multiforme (EM) and Stevens-Johnson Syndrome (SJS) are both immune-mediated skin conditions with similar clinical presentations, but they have distinct etiologies and varying management strategies. The main differences between the two conditions are:

  1. Desquamation: EM major is characterized by limited desquamation (peeling) on 1-2% of the body surface area, while SJS involves desquamation on higher but less than 10% of the body surface area.
  2. Lesions: Both EM and SJS may present with erythematous, targetoid lesions, but the lesions in EM are typically raised or papular, while those in SJS are flat, macular with ill-defined borders that may progress to vesicles and bullae followed by skin sloughing.
  3. Mucosal Involvement: SJS is associated with significant mucosal involvement, while EM has minimal mucous membrane involvement.
  4. Clinical Spectrum: EM represents a spectrum of disease, with EM minor being the most mild and toxic epidermal necrolysis (TEN) being the most severe. SJS, on the other hand, is considered a separate condition that may represent the same process as TEN but with different severity.
  5. Management: The management of EM and SJS differs significantly. Most cases of EM major require hospitalization for supportive care, while SJS may have more severe complications and require more intensive treatment.

It is essential to differentiate between these two conditions as their management and prognosis vary significantly. A thorough clinical examination and consideration of the patient's history, including recent medications or infections, can help distinguish between EM and SJS.

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  • What is the Difference Between Erythema Multiforme and Stevens Johnson Syndrome?
  • Comparative Table: Erythema Multiforme vs Stevens Johnson Syndrome

    • Comparative Table: Erythema Multiforme vs Stevens Johnson Syndrome

    Erythema Multiforme (EM) and Stevens-Johnson Syndrome (SJS) are both immune-mediated skin conditions, but they have distinct differences in their clinical presentation and management. Here is a table comparing the two conditions:

    Feature Erythema Multiforme Stevens-Johnson Syndrome
    Hallmark Lesion Raised, papular, typical target lesions with well-defined borders and three different zones Flat, macular with ill-defined borders that may progress to vesicles and bullae followed by skin sloughing
    Distribution of Lesions Predominantly on the extremities Widespread, involving less than 10% of the body surface area
    Mucosal Involvement Common, but less severe than SJS Less common than EM, but more severe
    Causes Most commonly caused by infections, such as herpes simplex virus (HSV-1) Most commonly caused by medications, but can also be caused by infections and other factors
    Management Symptomatic treatment, usually self-resolving aggressive management in a burn unit or intensive care setting, mortality can reach up to 30%

    It is essential to differentiate between EM major and SJS/TEN, as they markedly differ in management and prognosis.

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    Guilherme Mazui

    Guilherme Mazui is graduated in journalism from the Federal University of Minas Gerais (UFMG) and a master's degree in Communication from the University of São Paulo (USP). In addition, he has experience in advertising writing and has worked as a content editor in several companies.