Erythema multiform (figure 1-11) is an acute inflammatory condition that is easily
observed because of a redness of the mucosa or the skin. It occurs in many forms on
various parts of the body. Young adults are most commonly affected. The oral mucous
membranes are frequently involved, including vesicle rupture that leaves painful oral
ulcerations. The lips often exhibit crusted ulcerative lesions. Lesions appear rapidly
(within 10 to 14 days) and persist several days or longer. The symptoms are treated,
with spontaneous remissions occurring. Recurrence is common. If areas other than the
skin and the mucous membranes are involved (such as the eye or the genitalia), the
possibility of a syndrome complex exists.
NOTE: Raw, easily bleeding gingival tissues may represent an allergic response. In
this patient, a pseudomembrane has developed over the gingiva. Lack of
normal oral function and decreased oral cleansing caused by extreme discomfort
allowed this buildup of ulcerative tissue.
Figure 1-11. Erythema multiform.
1-48. ALLERGIC MANIFESTATIONS
a. Common Symptoms and Causes. The allergic condition called
angioneurotic edema may be related to food allergy, hypersensitivity, local infection,
and endocrine or emotional disturbances. The characteristic symptom is rapid swelling
of the affected tissue in 5 to 30 minutes with itching and burning sensations present.
The areas most commonly involved are the skin about the eyes and chin, the lips, and
the tongue. A major concern is the potential for laryngeal edema and airway
compromise. The symptoms are treated.