Erythema Multiforme and Toxic Epidermal Necrolysis
Description of the Disease and Clinical Picture
The exact pathogenesis of these two conditions is not known, but it is presumed that they are based on direct harmful effects or immune reactions to certain chemicals, drugs, infections, or neoplasms. The difference between these two conditions is still not entirely clear, both in human and veterinary medicine. Lesions appear on the skin, mucocutaneous junctions, and in the oral cavity; they are usually diffuse and acute in onset. Erythema Multiforme is characterized by erythematous macules or slightly raised papules that spread peripherally and fade at the center, giving the lesions a ring-like appearance. In Toxic Epidermal Necrolysis, erythema first appears on the skin, followed by the development of vesicles, bullae, necrosis, and ulcerations. Systemic disturbances such as pyrexia, anorexia, lethargy, and depression are present. Cutaneous pain and a positive Nikolsky sign are also present.
 
Therapy
The diagnosis is established by ruling out other diseases and through histopathological examination of altered skin samples. The treatment involves discontinuing all drugs the patient has been taking, fluid and electrolyte replacement, and lesion treatment aimed at preventing infection and sepsis. In severe cases, the use of corticosteroids in immunosuppressive doses is necessary. Erythema Multiforme spontaneously resolves after 3-4 weeks, while Toxic Epidermal Necrolysis requires months-long treatment. Despite therapy, in about 30% of cases, the disease is fatal.
 
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