Enanthem: Definition, Differences With The Exanthema, Symptoms, Causes And Treatment

It is an injury that is characterized by a rash of small spots of very red color, which is especially seen in the mucous membranes.

These vesicular lesions usually occur in the area of ​​the mouth and pharynx.

Differences between exanthemas and enanthemias

A rash is a very diffuse and more or less extensive skin rash along the surface of the body.

While the enantema is the skin rash that manifests on the surface of the mucous membranes that line the natural cavities, especially in the mouth and pharynx.

As they are very frequent manifestations of several infectious diseases caused by viruses, they are classified as exanthematic diseases.

The most common, although they are not the only ones, are measles, rubella and chicken pox, all of them very contagious and that can be contracted during the first years of life.

Eruptive lesions can be caused by the presence of the viruses themselves in the skin, mucous membranes or by a reaction triggered by the body’s defenses.

However, the appearance of rash lesions varies according to the disease and its time of evolution.

In fact, if in measles the lesions consist of small spots (or macules), the lesions of rubella reveal smaller spots with a slight relief (or papules).

While in varicella, although beginning to show macules, they are successively transformed into papules and then vesicles, consisting of a liquid that, when dry, causes the formation of scabs that end up falling.


In the eruptions in the mucous membranes, the most characteristic corresponds to the so-called Koplick spots , typical of measles, small lesions in the roof of the mouth with an appearance similar to canker sores.

The presence and characteristics of exanthemas and enanthemas are very important for the diagnosis of an exanthematous disease.

However, the eruptions themselves do not usually cause serious repercussions on the health of the patient, since in most cases they disappear spontaneously after a few days after they have manifested.


It usually occurs in diseases such as:

Subject exanthema: It is a viral disease, characterized by high fever and rash. It is caused by a human herpe virus 6, this condition has enanthem as erythematous papules located on the soft palate and uvula also called Nagayama spots.

Measles: It is a viral disease of infectious type that is commonly shown at the stage of childhood and adolescence. The enanthem that appears is known as Köplik’s spots, these will appear in the early stages of measles development.

Scarlet fever: It is an infectious, contagious, bacterial type that usually occurs in people over three years of age.

The responsible bacterium is the group A beta hemolytic streptococcus. The enanthemata occur at the buccal level, very marked on the tongue, which is covered by a yellowish white exudate. The tongue papillae protrude hyperemic and thickened and give a raspberry appearance on the tongue.

Chickenpox: It is a viral disease with acute infectious-contagious characteristics, caused by the varicella-zoster virus. Injuries or enanthae appear in the mouth and usually in a small number.

The lesions begin as a small blister or vesicle, which ruptures rapidly, causing a shallow ulcer with a yellowish white background surrounded by an erythematous halo.

Usually these ulcers are not painful or asymptomatic, but this enanthem may present with painful erosions in the oropharynx, conjunctivae or vaginal mucosae.

Pospischill Feyter disease: It occurs in infants and young children, it is a variant of the herpes simplex virus. The characteristic eruptions occur in the perioral area.

Kawasaki syndrome or also called mucocutaneous ganglion syndrome: It is a vasculitis with the presence of fevers and exanthemas, it is multisystemic and epidemic. The enantema presents the characteristics of afrabmbued language.

Herpes simplex: This presents two serotypes, HSV I, which causes oral lesions, and HSV 2, associated with genital infections, although both serotypes are capable of inducing buccogenital lesions.

The enantema appears as a vesicular eruption in the oropharyngeal mucous membranes in the form of small clusters, the lesions may be covered by a yellowish pseudomembrane.

Escalating skin syndrome: It is also known as Ritter’s disease, it usually occurs in newborns or children under 5 years of age, which may affect older children and, in rare cases, adults. It presents enanthem or Nagayama spots, with erythematous papules on the soft palate and uvula.

Mononucleosis: It is an acute infectious disease, usually occurs in children, adolescents and young people. The responsible agent is the Epstein-Barr virus, it penetrates the body and is found in the lymph nodes and tonsils.

The enantema appears between day 5 and day 17 and is described as small petechial conglomerates with a diameter of 1 to 2 mm, at the edge of the soft and hard palate.

Rubella: It is produced by a single-stranded RNA virus, of the genus Rubivirus, of the family Togaviridae, consisting of a petechial or macular enantema on the soft palate, called the Forcheimer sign, which occurs during the prodromal phase or the first day of eruption.


The treatment usually depends on the cause, but different treatments of oral type are used that are coadjuvants for this type of gingivo-periodontal lesions, such as, for example, 0.12% chlorhexidine rinses.

Mouthwashes based on aluminum and magnesium hydroxide gels, which are applied 3 times a day.

Coupled with this, a soft diet is recommended to avoid discomfort.