Clinical Analysis Of 200 Patients Diagnosed As Erythema Multiforme

ObjectiveTo present epidemiology,triggers,clinical feature,laboratory tests,treatment and prognosis in Erythema multiforme(EM).to explore the treatment of corticosteroid,Intravenous Immunoglobulin(IVIG),and antiviral drugs,etcetera in EM.MethodsThe clinical data of 200 patients with EM were collected in the General Hospital of Tianjin Medical University from 2012 to 2017.SPSS 19.0 software was used to process datas and a retrospective analysis was made.ResultsGeneral conditions: Of the 200 patients with EM,94 were male and 106 were female.Male to female ratio was 1:1.12.The average age of onset was 45.19±18.47 years old and ranged from 9~92 years old.According to the severity of illness,it was divided into EM minor,consisted of 136 cases,and severe EM(Stevens-Johnson syndrome,SJS),64cases;No statistical difference in the gender of the incidence of EM minor and SJS(p>0.05);On the age of onset,in patients <30years,the proportion of patients with SJS was significantly higher than in EM minor(p<0.05).no significant difference between other groups.EM occurred mainly in spring and autumn.Clinical manifestations:The lesions of EM minor were mainly scattered throughout the body(96 cases)and extremities(20 cases);SJS had varying degrees of skin lesions and ? 2mucosal involvement.37%(74/200)of EM had varying degrees fever,27.5%(55/200)had muscle aches,tiredness,etcetera.30%(60/200)showed typical target lesions.Inducement and medication history:25.5%(51/200)had obvious incentives,24.5%(49/200)had suspected drug allergies,the longest incubation stage was 30 days,and the shortest was 2 days.The average incubation stage was 8.8±8.5 days.analgesic-antipyretic(15/49),antibiotics(10/49),and antiepileptics(10/49)were the most common.Laboratory examination:40.5%(81/200cases)had leukocytosis,7.5%of EM(15/200cases)had leukopenia,36%(72/200cases)had lymphocytosis or monocytosis.7.5%(15/200 cases)had Albumin reduction,13%(26/200cases)increased in ALT,9%(18/200cases)increased in AST and 2.5%(5/200cases)increased in Cr.And 43.75%(21/48cases),70.73%(58/82cases),85%(68/80cases),49.25%(33/67cases)increased in ESR,CRP,D-D,IgE,respectively.Treatment:In EM minor,65 patients were treated with antiviral and corticosteroid,53 were treated with corticosteroid,and10 were treated with antiviral.no significant difference in therapeutic effect.(p>0.05).6patients only received antihistamines,1 received only triptolide,1 used penciclovir and cyclosporine A;in SJS,23 received corticosteroid treatment alone.23 were treated with antiviral and corticosteroid,7 were treated with glucocorticoid and IVIG,and 11 were treated with glucocorticoid,IVIG and antiviral.No significant difference in the 4 methods(P> 0.05).Outcome and prognosis:1 case died because of acute respiratory failure,the remaining 199 patients were mitigated obviously.The mortality rate was 0.50%.The mean time of postoperative hospital stay was 9.5±4.7days.The shortest was 1 day and the longest was 30 days.The hospital stay of EM minor was significantly shorter than that of SJS(P<0.05).3 had complications of fungal infections caused by glucocorticoids.and cured after treatment.ConclusionEM minor is often self-limited and related to infection,especially viral infections,The treatments include supportive therapy,timely antiviral and glucocorticoid.EM minor has a good prognosis;In SJS,it's important to check and avoid suspicious drugs and provide supportive treatment to reduce complications.The glucocorticoid is still the main treatment for SJS in China.No consensus has been reached on the combination of corticosteroids and IVIG.