1. Kill Extension Manager by Task Manager( Windows ) or Force Quit( Mac ).
2. Remove files below.
Windows( EM CS5.5 and earlier ):"C:\Users\<UserName>\AppData\Roaming\Adobe\Extension Manager CS\Configuration\Extensions\exman_uiPreferences.xml"
Windows( EM CS6 ):"C:\Users\<UserName>\AppData\Roaming\Adobe\Extension Manager CS6\Configuration\exman_uiPreferences.xml"
Mac:"/Users/<UserName>/Library/Preferences/Adobe/Extension Manager CS/exman_uiPreferences.xml"
3. Launch Extension Manager again as administrator.
4. If steps above still do not work, you can check if you have some flex-based software installed on your machine. Some of them conflict with Extension Manager, such as Flash FireBug. Uninstall them or delete all files in the folders below after backup.
Windows:"C:\Users\<UserName>\AppData\Roaming\Macromedia\Flash Player\#Security\FlashPlayerTrust"
Mac:"/Users/<UserName>/Library/Preferences/Macromedia/Flash Player/#Security/FlashPlayerTrust"
"/Library/Application Support/Macromedia/FlashPlayerTrust"