A 38-year-old male reported to the Department of Oral Medicine and Radiology, with a complaint of painful mouth due to ulcers since 20 days. Patient was apparently normal 20 days ago following which he developed tooth pain in his upper left back tooth region for which he chewed cloves to overcome pain. After three days he noticed ulcers in his mouth making him difficult in taking solid and liquid foods due to pain which made him to visit a private practitioner where he was administered gentamycin. The oral condition worsened furthermore with the emergence of dermal lesions. General physical examination revealed a history of fever, malaise and headache since two days.Extra oral examination revealed multiple concentric target or iris lesions on upper & lower extremities. Haemorrhagic crustations with clinically evident bleeding were seen on the lower lip with bilateral submandibular lymphadenopathy. Intraorally multiple encrustations were noticed on the upper and lower labial mucosa which were irregular, tender & associated with bleeding. Diffuse erosions and ulcerations with erythematous borders were present on the upper and lower labial mucosa, bilateral buccal mucosa, dorso-ventral surfaces of the tongue and soft palate which were associated with bleeding on palpation and were tender. The dorsum of the tongue is covered with a white patch which is scrappable mimicking coated tongue and is tender [Table/ Fig-1]. Considering the history, Haemorrhagic crustations involving the vermilion border of upper & lower lip along with generalized involvement of oral mucosa and symmetric acral distribution of target/iris/bull eye shaped dermal lesions [Table/ Fig-2] (typical pathognomic feature) in an acute phase a diagnosis of erythema multiforme is made. As mentioned in the review of literature even the histopathological examination remained unremarkable [Table/ Fig-3] The patient was commenced on systemic corticosteroids (Wysolone) 10mg t.i.d. along with benzydamine hydrochloride (tantum) oral rinse for a week. As the lesions were regressing clinically with gradually decreasing discomfort after 15 days [Table /Fig-4,5], systemic steroids were tapered by 10mg for every seven days till a maintenance dose of 5mg. The patient was subjected to quadrant scaling and oral hygiene instructions were given. Total resolution of ABSTRACTAdverse drug associated mucocutaneous reactions having a preponderance to occur above 1% include urticaria, angioedema, photosensitivity, fixed drug eruptions and Erythema Multiforme (EM). EM is an acute inflammatory disease of the skin and mucous membranes that causes a variety of skin lesions-hence named 'multiforme'. The aetiological spectrum of EM is wide and is attributed to infectious agents, drugs and food additives. EM is diagnosed based on stringent clinical findings which are pathognomic as microscopic evaluation carries least significance. We report a case of a 38-year-old male who presented with a complaint of severe oral & cutaneous lesions making him difficult to eat & drink. History rev...

No abstract

No abstract

No abstract