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Laryngeal lesions in erythema multiforme exudative: causes, symptoms, diagnosis, treatment
Last reviewed: 07.07.2025
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Erythema multiforme exudative of Hebra is a rare pruritic dermatosis, manifested by intensely itchy papules, elevated above the skin surface, which is an acute cyclic disease, characterized by sudden symmetrical rash on the skin of the extensor surfaces of the extremities.
In some cases, dermatological manifestations are preceded by a prodromal period, manifested by general malaise, headache, chills, fever, and sometimes joint pain. The disease usually begins in early childhood and, recurring, can continue into adulthood.
[ Pathological anatomy of laryngeal lesions in erythema multiforme exudative
The rash consists of light red and livid round dense papules with a diameter of 0.3-1 cm. Within 3-4 days, these rashes increase, and their central part sinks and becomes cyanotic. When the rashes merge, figures of various shapes and polycyclic in development are formed. In some cases, a new nodule is formed in the center of the rash, forming the same concentric circle as the first papule. In some cases, the mucous membrane of the lips, oral cavity, pharynx and larynx is affected.
Symptoms of laryngeal lesions in erythema multiforme exudative
The main subjective symptoms of erythema multiforme exudative are severe itching, objective evidence of which are pronounced scratches, often infected. Because of this, the primary rash soon transforms into a small focus of necrosis, often into a vesicle with serous contents, which often suppurates. Over time, the skin becomes lichenified, hair follicles atrophy, and axillary and inguinal lymph nodes enlarge. Eosinophilia is often detected in the blood.
Blisters on the oral mucosa and the lip border, smaller in size than those seen in pemphigus, quickly burst, revealing bleeding, dirty-colored erosions. The lips swell, their red border becomes covered with bloody and dirty crusts and cracks. Eating is difficult due to significant pain.
Similar rashes are observed in the larynx, in particular on the epiglottis, aryepiglottic and vestibular folds, rarely on the mucous membrane of the laryngeal ventricles. These lesions impair the swallowing function and, depending on the localization, cause dysphonia of varying degrees. The danger of laryngeal localization of erythema multiforme exudative is the possibility of secondary complications with severe edema and obstructive stenosis of the larynx.
A characteristic feature of erythema multiforme exudative is its relapses; there are patients in whom the disease recurs once or twice a year, more often in spring and autumn. Usually the first excess or relapse lasts 2-3 weeks; general symptoms and fever, if they occur, last only a few days, but there are also severe cases with a longer duration. Isolated cases of erythema multiforme exudative of the larynx have not been described.
Diagnosis of laryngeal lesions in erythema multiforme exudative
Diagnosis does not cause any particular difficulties, since oropharyngolaryngeal lesions are accompanied by characteristic rashes on the skin.
If skin manifestations are preceded by lesions of the mucous membrane of the upper respiratory tract, then the diagnosis of multiform exudative erythema of the larynx is difficult until typical skin rashes appear. Multiform exudative erythema of the larynx should be differentiated from secondary syphilis, herpetic laryngitis, lichen planus, etc.
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Treatment of laryngeal lesions in erythema multiforme exudative
Treatment of oropharyngeal and laryngeal manifestations of erythema multiforme exudative is reduced to the use of alkaline rinses, lubrication of rashes with a 1% solution of methylene blue, inhalation of antibiotics mixed with hydrocortisone. To reduce pain, use powders with anesthesin powder, applications of 3-5% cocaine solution, 3% dicaine solution.
What is the prognosis for laryngeal lesions in erythema multiforme exudative?
Laryngeal lesions in erythema multiforme exudative always have a favorable prognosis.