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Results for “Erythema Multiforme”

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PubMed2000

[Erythema multiforme in children versus Stevens-Johnson syndrome].

UNLABELLED: 30 children treated between 1984-98 for erythema multiforme (versus SJS) in Department of Allergology at the Children's Memorial Health Institute in Warsaw. 25 children suffered from erythema multiforme minor and 5 suffered from Stevens-Johnson Syndrome. Before symptoms of the illness 13 children had been treated with antibiotics and 27 children demonstrated different symptoms of infections, mostly viral. Drug therapies and viral or bacterial infections probably induce symptoms in patients susceptible to erythema multiforme or severe versus Stevens-Johnson Syndrome. CONCLUSION: 1. Erythema multiforme (EM) rather seldom occurs in children. The Most commonly its course is benign (EM minor). In another type of erythema multiforme--Stevens-Johnson Syndrome (EM major), in which mucous membranes are involved, the course of disease and the prognosis are always severe. 2. Both viral and bacterial infections as well as administered drugs play the important role in the etiopathogenesis of erythema multiforme. 3. The treatment of erythema multiforme in children is symptomatic (general and local). In Stevens-Johnson Syndrome early administration of glicocorticoids is recommended. Children with bacterial infection (contagion, contamination) should be treated with antibiotic.

Adolescent↗

PubMed1997

Erythema multiforme and toxic epidermal necrolysis: a comparative study.

Erythema multiforme and toxic epidermal necrolysis were considered in the past to be different aspects in the spectrum of a single disease. Using standard histology and immunochemistry we present evidence that the inflammatory infiltrates of erythema multiforme and toxic epidermal necrolysis are strikingly different both in density and nature. Erythema multiforme has a high density cell infiltrate rich in T-lymphocytes. By contrast, toxic epidermal necrolysis is characterized by a cell-poor infiltrate in which macrophages and dendrocytes predominate with a strong immunoreactivity for TNF-alpha. Such differences indicate a distinct pathogenesis for these diseases.

Adolescent↗

PubMed1995

Persistent erythema multiforme: report of two new cases and review of literature.

Within the clinical spectrum of erythema multiforme, two subgroups have been recently identified: recurrent erythema multiforme and the rare persistent erythema multiforme. Two additional cases of persistent erythema multiforme are described. Lesions were widespread and resistant to traditional therapies. One of the patients had an underlying malignancy; the other exhibited a symptom complex characterized by fatigue, fever, sore throat and lymphadenopathy, and an abnormal Epstein-Barr virus serologic profile suggestive of endogenous reactivation of Epstein-Barr virus infection.

Adult↗

PubMed1995

Erythema-multiforme-like eruption due to topical contactants: expression of adhesion molecules and their ligands and characterization of the infiltrate.

Erythema-multiforme-like reactions are a rare manifestation of allergic contact sensitivity, the pathomechanisms of which and their possible relationship to erythema multiforme remain unclear. We present our histopathological and immunohistochemical findings regarding the expression of several adhesion molecules and immunophenotypic markers of the infiltrate in skin biopsy specimens from 2 cases of erythema-multiforme-like reactions due to contact sensitizers and 3 cases of typical post-herpetic erythema multiforme. The histopathological pattern of erythema-multiforme-like reactions was characterized by an upper-dermal perivascular lymphoid infiltrate with exocytosis and keratinocyte necrosis; in 1 of the cases, there were foci of spongiosis and an admixture of eosinophils in the infiltrate. In comparison with biopsy specimens from cases of typical erythema multiforme, in both cases of erythema-multiforme-like reactions, the epidermal expression of ICAM-1 was more prominent, the % of CD4+ cells in the infiltrate was higher and the % of CD69+ cells was lower. There were no other significant differences in the cell phenotype of the infiltrate or in adhesion molecule expression in biopsy samples from both disorders.

Adult↗

PubMed2005

Use of steroids for erythema multiforme in children.

QUESTION: I recently diagnosed an erythema multiforme rash in several patients, two of whom had the major variant, Stevens-Johnson syndrome. Should these patients be managed with corticosteroids? ANSWER: In most cases, mild erythema multiforme is self-limited and resolves in 2 to 4 weeks. Stevens-Johnson syndrome is a serious disease that involves the mucous membranes and lasts up to 6 weeks. There is no indication for using steroids for the mild form. Use of steroids for erythema multiforme major is debatable because no randomized studies clearly indicate which children will benefit from this treatment.

Child↗

PubMed2002

Celecoxib-induced erythema multiforme with glyburide cross-reactivity.

Erythema multiforme is an acute inflammatory skin reaction that often is caused by drugs, especially sulfonamides and their derivatives. Celecoxib, a cyclooxygenase-2 inhibitor, is a sulfonamide derivative commonly prescribed to treat arthritis in patients who cannot tolerate or who have a contraindication for taking traditional nonsteroidal antiinflammatory agents. A 57-year-old man with a previously undocumented sulfa allergy experienced an allergic skin reaction and had difficulty breathing secondary to throat swelling. His condition was believed to be erythema multiforme associated with the introduction of celecoxib into his drug regimen. His drug therapy was discontinued, but a subsequent reaction occurred when the sulfonamide derivative glyburide was reintroduced. It is important for clinicians to obtain a careful history and perform a thorough medical evaluation in all patients receiving sulfonamides and their derivatives, as a potentially life-threatening allergic reaction may be prevented.

Celecoxib↗

PubMed1999

Erythema multiforme after application of aural Gentisone HC drops.

Erythema multiforme is an uncommon acute self-limiting condition characterized by mucocutaneous lesions of varying severity with a variable pattern of recurrence. This is a case of a four-year-old girl who developed erythema multiforme secondary to topical aural application of Gentisone HC drops (hydrocortisone acetate one per cent, gentamicin 0.3 per cent (as sulphate)) prescribed as a treatment for otorrhoea following grommet insertion. The clinical features are described and the literature reviewed. To my knowledge, this is the first reported case in the literature, of erythema multiforme secondary to a topical aminoglycoside/steroid preparation.

Anti-Bacterial Agents↗

PubMed1992

Erythema multiforme reaction to patch testing.

A young woman developed erythema multiforme in association with multiple patch test reactions. Sequential patch testing revealed 2 true positive reactions (colophony and fragrance mix), and was not associated with flare of erythema-multiforme-type lesions. The development of erythema multiforme should be included in the list of possible adverse reactions to patch testing, albeit a rare occurrence.

Adult↗

PubMed1983

[Clinical and etiological aspects of erythema multiforme. A propos of 40 cases].

The authors analyse 40 cases of erythema multiforme (including twenty children under fifteen) seen over a five-year period at the Sick Children's Hospital in Bordeaux, Bullous erythematous target lesions of the skin were associated, in most cases, with pluri-orificial ulcerations on the mucous membranes and, less frequently, with more or less severe systemic or visceral symptoms. Borderline cases were observed, associating features of erythema multiforme simplex and of Lyell disease with variable degrees of dermoepidermal blistering and epidermal necrosis. Infection (32.5% of cases) is a more common etiology in children than in adults; the main pathogens are herpes simplex virus, vaccinia pox virus, and Mycoplasma pneumoniae. Drug-induced forms (37% of cases), which are more often seen in adults than in children, are usually due to sulfonamides or antiinflammatory agents. In 30% of cases, no etiology could be demonstrated. Attention is drawn to the frequency of facial vespertilial erythema, as well as the possible occurrence of severe conjunctival sequellae. The connections between erythema multiforme, fixed drug-induced eruptions, and Lyell disease are discussed: only the last, which implies dermoepidermal cleavage, can be categorized with erythema multiforme. The staphylococcal scalded skin syndrome, in which the epidermolysin of Staphylococcus aureus type II 71 is responsible for a superficial cleavage, proceeds from entirely different mechanisms and should be regarded as totally distinct from erythema multiforme.

Adolescent↗

PubMedDate not supplied

[The use of sorption therapy in the combined treatment of exudative erythema multiforme].

Polymethylsiloxan, a sorbent, was used in combination with enterosorption with thermal alkaline mineral water in a complex treatment of patients (n = 37) with multiform exudative erythema. During the 45-min therapeutic session the sorbent-applicator was changed three times. The above therapy makes for rapid healing of erosions, reduces treatment time periods, prevents recurrences irrespective of the causative factors of inductors of the disease under study.

Combined Modality Therapy↗

PubMed1990

[Role of herpes simplex virus in the development of exudative erythema multiforme].

The paper presents analysis of current knowledge on etiology and immunopathogenesis of multiform exudative erythema (MEE). Among a variety of pathogenetic actions of herpes simplex on immune system are those relevant to MEE onset. These variants are dealt with in detail. The view on MEE as resultant from herpes simplex infection promises appearance of new prospective modes of etiotropic therapy.

Adult↗

PubMed1992

Mast cells in oral erythema multiforme.

We compared the number of mast cells in erythema multiforme lesions, in clinically healthy mucosa between the EM attacks and in healthy mucosa from healthy volunteers. The mast cell count in patients with erythema multiforme was numerically higher than in healthy controls, but the differences were not statistically significant. In erythema multiforme lesions the mast cell count was low in the intensely inflamed superficial lamina propria, but high in normal appearing mucosa between the attacks suggesting local mast cell degranulation in the most intensely inflamed areas.

Adolescent↗

PubMed1987

Oral acyclovir prevents herpes simplex virus-associated erythema multiforme.

A young woman suffering from recurrent erythema multiforme associated with relapsing gluteal herpes simplex is presented, in whom long-term treatment with oral acyclovir prevented herpes episodes as well as erythema multiforme.

Acyclovir↗

PubMed1985

Erythema multiforme associated with contact dermatitis.

A garment worker developed erythema multiforme concurrently with allergic contact dermatitis of the hands. Patch testing revealed sensitivity to nickel (which was present in her scissors) and to paraphenylenediamine (a commercial dye). During the course of the patch-test evaluation, both the hand dermatitis and the erythema multiforme became exacerbated. Later, patch testing to only nickel sulfate resulted in the development of erythema multiforme on the face and hands. The allergic pathogenesis, involving the absorption of an allergen through the skin and resulting in a type III allergic reaction from nickel, is discussed.

Allergens↗

PubMed1983

Photosensitive recurrent erythema multiforme.

A case report of photosensitive recurrent erythema multiforme occurring in a 31-year-old man is presented herein. Lesions clinically and histologically resembling erythema multiforme were reproduced with light testing. The patient's lesions appeared to respond to both oral prednisone and hydroxychloroquine.

Adult↗

PubMed1993

Erythema multiforme associated with an outbreak of Mycoplasma pneumoniae function.

AIMS: To document the association between erythema multiforme and Mycoplasma pneumoniae. METHOD: All cases of erythema multiforme presenting to the dermatology department of Waikato Hospital over the summer of 1992/3 were tested for mycoplasma serology. Trends in recorded cases of M pneumoniae infection were examined from data supplied by the virology department of Waikato Hospital. RESULTS: Four of seven cases of erythema multiforme were due to M pneumoniae infection. This was associated with a marked local increase in the number of M pneumoniae infections recorded in our hospital. CONCLUSION: Mycoplasma serology is an important investigation in the management of erythema multiforme, especially when associated with an outbreak of M pneumoniae infections.

Adult↗

PubMed1989

Epidermal autoantibodies in erythema multiforme.

We report a case of refractory erythema multiforme associated with atypical epidermal autoantibodies. The patient was a 63-year-old woman with clinical and histologic features of erythema multiforme and a large mediastinal T cell lymphoma. Immunofluorescence studies disclosed high serum titers of cell surface antibodies against epidermal keratinocytes in a pattern typical of pemphigus vulgaris. The epidermal antigen reacting with these circulating antibodies was characterized by incubating 14C-labeled keratinocytes with serum. The patient's serum pattern precipitated multiple proteins keratinocytes antigens), but not the 130,000- and 85,000-dalton polypeptides characteristic of pemphigus vulgaris. Thus autoantibodies reacting selectively with non-pemphigus vulgaris epidermal keratinocyte antigens may be the cause of a false-positive immunofluorescence test for pemphigus vulgaris.

Aged↗

PubMed2002

Correlations between clinical patterns and causes of erythema multiforme majus, Stevens-Johnson syndrome, and toxic epidermal necrolysis: results of an international prospective study.

BACKGROUND: It was proposed that Stevens-Johnson syndrome and toxic epidermal necrolysis differed from erythema multiforme majus by the pattern and localization of skin lesions. OBJECTIVE: To evaluate the validity of this clinical separation. DESIGN: Case-control study. SETTINGS: Active survey from 1989 to 1995 of 1800 hospital departments in Europe. PATIENTS: A total of 552 patients and 1720 control subjects. METHODS: Cases were sorted into 5 groups (erythema multiforme majus, Stevens-Johnson syndrome, Stevens-Johnson syndrome-toxic epidermal necrolysis overlap, toxic epidermal necrolysis, and unclassified erythema multiforme majus or Stevens-Johnson syndrome) by experts blinded as to exposure to drugs and other factors. Etiologic fractions for herpes and drugs obtained from case-control analyses were compared between these groups. RESULTS: Erythema multiforme majus significantly differed from Stevens-Johnson syndrome, overlap, and toxic epidermal necrolysis by occurrence in younger males, frequent recurrences, less fever, milder mucosal lesions, and lack of association with collagen vascular diseases, human immunodeficiency virus infection, or cancer. Recent or recurrent herpes was the principal risk factor for erythema multiforme majus (etiologic fractions of 29% and 17%, respectively) and had a role in Stevens-Johnson syndrome (etiologic fractions of 6% and 10%) but not in overlap cases or toxic epidermal necrolysis. Drugs had higher etiologic fractions for Stevens-Johnson syndrome, overlap, or toxic epidermal necrolysis (64%-66%) than for erythema multiforme majus (18%). Unclassified cases mostly behaved clinically like erythema multiforme. CONCLUSIONS: This large prospective study confirmed that erythema multiforme majus differs from Stevens-Johnson syndrome and toxic epidermal necrolysis not only in severity but also in several demographic characteristics and causes.

Adult↗