Pathology
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Atlas of dermatopathology
Josef Feit, Hana Jedličková, Günter Burg, Luděk Matyska, Spasoje Radovanovic et al.
Index
Contents
Authors
ExpSys: non-tumors
ExpSys: tumors
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+ Introduction
+ Literature
+ Support
+ Skin biopsy
+ Non-tumorous skin diseases
+ Skin tumors
+ Cysts of the skin and subcutis
+ Soft tissue lesions
+ Some lesions of the oral cavity
+ Dermatovenerology
+ Collection of histological slides by prof. Günter Burg
+ Collection of histological slides by prof. Werner Kempf
+ Collection of histological slides of dr. Ram Chandra Adhikari
Erythema multiforme
Etiology, pathogenesis
  • idiopathic, reaction to various infections (Herpes simplex, mycoplasma), drugs (sulphonamides)
  • tissue damage due to humoral and cell mediated immunity
Clinical signs
  • younger patients, recurrencies in the fall and spring
  • symetric eruption on the trunk, distal extremities, palms, backs of the hands, mucous membranes
  • multiform (target) lesion is often annular with erythematous ring and vesicle in the centre
  • red, cyanotic colour
  • Toxic epidermal necrolysis: generalized confluent lesions with widespread epidermal denudation
  • the most severe form is Lyel's disease, disseminated form with blisters and ulcers especially of mucous membranes is called Stevens-Johnson's syndrome
Pictures

Erythema multiforme, detail: Erythema multiforme, Clinical picture (1043)

Erythema multiforme, large bullae: Erythema multiforme, Clinical picture (1044)

Erythema multiforme: Erythema multiforme, Clinical picture (1045)

Erythema multiforme, typical iris-shape lesions: Erythema multiforme, Clinical picture (1046)

Erythema multiforme: Erythema multiforme, Clinical picture (1047)

Erythema multiforme, palms: Erythema multiforme, Macro (3791) Erythema multiforme, Macro (3792) Erythema multiforme, Macro (3793) Erythema multiforme, Macro (3794)

Erythema multiforme, conjunctiva: Erythema multiforme, Clinical picture (1050)

Further examples of erythema multiforme:

Histology

Variable epidermal necrosis; vacuolar degeneration of the basal layer; sometimes subepidermal blisters. In some cases there is a prominent edema of the superficial dermis.

Pictures

Erythema multiforme: Erythema multiforme, HE 100x (2545)

Another case: Erythema multiforme, HE 20x (116) Erythema multiforme, HE 40x (117)

Another case: Erythema multiforme, HE 10x (118) Erythema multiforme, HE 40x (119)

Another case: Erythema multiforme epidermal with bulla, EEM, HE 20x (4659)

Another case: Erythema multiforme, HE 10x (552) Erythema multiforme, HE 40x (553)

Another case: Erythema exudativum multiforme, HE 20x (1269)

Another case: Erythema exudativum multiforme, HE 10x (1280) Erythema exudativum multiforme, HE 20x (1281) Erythema exudativum multiforme, HE 40x (1282)

Drug related exanthema can be of multiform pattern: Erythema multiforme, drug induced, HE 20x (120)

Case with prominent dermal edema (so called dermal type): Erythema multiforme, HE 2.5x (1275) Erythema multiforme, HE 10x (1274) Erythema multiforme, HE 40x (1276)

Another example of multiform reaction with prominent dermal edema: Erythema multiforme, multiform reaction, HE 20x (4863)

Erythema multiforme: Erythema multiforme, HE 40x (4190) Erythema multiforme dermal non bull, HE 40x (4250)

Erythema multiforme: Erythema multiforme with subepidermal bulla, HE 20x (4234)

Erythema multiforme: Erythema multiforme with subepidermal bulla, HE 20x (4239)

Erythema multiforme: Acute bullous multiform reaction, HE 40x (12871)

Erythema multiforme: Erythema multiforme with subepidermal bulla, HE 20x (4240)

Erythema multiforme, dermal, with tiny vesicle: Erythema multiforme dermal non bull, HE 20x (4248)

Erythema multiforme, early, non-bullous: Erythema multiforme, early, HE 100x (6135)

Erythema multiforme with prominent edema of the papillary corium, without epidermal necroses: Erythema multiforme, HE 40x (5130)

Erythema multiforme, acute, non-bullous: Erythema multiforme, HE 60x (10164)

Erythema multiforme: Erythema multiforme, HE 60x (13002)

Erythema multiforme: Erythema multiforme, bullous, EEM, HE 40x (12677)

Erythema multiforme: Erythema multiforme, HE 40x (12877)

Erythema multiforme: Erythema multiforme, HE 40x (12878)

Erythema multiforme: Erythema multiforme, HE 40x (12879)

Erythema multiforme, early Lyell's syndrome: Erythema multiforme, incip. Lyell's syndrome, HE 40x (12880)