With or without precursory symptoms of malaise, gastric uneasiness or
rheumatic pains, the eruption suddenly makes its appearance, assuming an
erythematous, papular, tubercular or mixed character; as a rule, one
type of lesion predominates. The lesions tend to increase in size and
intensity, remain stationary for several days or a week, and then
gradually fade; during this time there may have been outbreaks of new
lesions. In color they are pink, red, or violaceous. Slight itching may
or may not be present. Exceptionally, in general cases, the eruption
partakes of the nature of both urticaria and erythema multiforme, and
itching may be quite a decided symptom. In some instances there is
preceding and accompanying febrile action, usually slight in character;
in others there may be some rheumatic swelling of one or more joints.

[Illustration: Fig. 11.
Erythema Multiforme, in which many of the lesions have become
bullous--Erythema Bullosum.]

#What type of the eruption is most common?#

The papular, appearing usually upon the backs of the hands and forearms,
and not infrequently, also, upon the face, legs and feet. The papules
are usually pea-sized, flattened, and of a dark red or violaceous color.

#Describe the various shapes which the erythematous lesions may assume.#

Often the patches are distinctly ring-shaped, with a clear
centre--_erythema annulare_; or they are made up of several concentric
rings, presenting variegated coloring--_erythema iris_; or a more or
less extensive patch may spread with a sharply-defined border, the older
part tending to fade--_erythema marginatum_; or several rings may
coalesce, with a disappearance of the coalescing parts, and serpentine
lines or bands result--_erythema gyratum_.

#Does the eruption of erythema multiforme ever assume a vesicular or
bullous character?#

Yes. In exceptional instances, the inflammatory process may be
sufficiently intense to produce vesiculation, usually at the summits of
the papules--_erythema vesiculosum_; and in some instances, blebs may be
formed--_erythema bullosum_. A vesicular or bullous lesion may become
immediately surrounded by a ring-like vesicle or bleb, and outside of
this another form; a patch may be made up of as many as several such
rings--_herpes iris_. In the vesicular and bullous cases the lips and
the mucous membranes of the mouth and nose also may be the seat of
similar lesions.

#What is the course of erythema