Erythema Multiforme; Sixty Six Case Series with Review of Literature

Abstract

Erythema multiforme (EM) is an acute, self-limited, and sometimes recurrent skin disease considered to be a hypersensitivity reaction associated with certain medications and infections. EM has recently been recognized as a distinct disease differentiated from the Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). The aim of this study was to evaluate the clinical and histopathological characteristics of patients with EM. The retrospective study included 66 patients who received outpatien t or inpatient treatment at the Dermatology department due to a diagnosis of EM between 2005 and 2017. Age, gender, etiological factor, recurrence, significant histopathological findings, presence of target lesions, mucosal involvement, and treatment metho ds were recorded. The 66 patients included 22 (33.3%) men and 44 (66.7%) women with a mean age of 36.7 ±13.9 years. The etiological factor was Herpes labialis in 36.4%, medication in 31.8%, Orf infection in 13.6%, and no etiological factor was detected in 18.2% of the patients. Although EM is a common entity in dermatology practice, there are a limited number of studies reporting on EM. The results indicated that EM can occur secondary to Orf infection.

Incidence of Erythema Multiforme among Patients with ORF Disease in Al-Kindy Teaching Hospital

“…It is also consistent with the results of the study that was carried out by Lerch M et al 1 who have stated that EM is particularly seen in the second and third decades of life. The current study revealed that 7 of our patients with EM were females and these results are in agreement with the results of Yavuz IH et al 21 who had also reported a higher percentage of EM among females (66.7% of their patients were females). The findings were also consistent with Samim F et al 22 who indicated EM is more common in women than men.…”

“…The results of the current study demonstrated that the mean age of the studied sample with ORF was 36.1 years. In addition, our findings revealed that 7 out of 9 patients with EM were less than 40 years of age and these findings are consistent with the finding of the study that was conducted by Yavuz I H et al 21 where they also found that the mean age of their patients with EM was 36.7 years. It is also consistent with the results of the study that was carried out by Lerch M et al 1 who have stated that EM is particularly seen in the second and third decades of life.…”

A Case Report: Clinical Efficacy of Combination Treatment of Dexamethasone and Azathioprine in Recurrent Erythema Multiforme

“…Erythema multiforme occurs in patients of all ages but is most prevalent in adolescents and young adults (the peak age of 20–40 years), 1 , 7 , 8 more often in male (male-to-female ratio of 2 to 3:1). 4 , 8 There are several precipitating factors associated with the development of EM, including infections (nearly 90% cases) and medications (10% cases).…”

“…Erythema multiforme (EM) is a rare immune-mediated mucocutaneous disorder with acute onset, sometimes recurrent, and sometimes self-limited. 1 , 2 The two main forms of EM are EM major with the involvement of two or more mucosal sites and EM minor with the involvement of one or none mucosal site. 3 The etiology of EM remains unknown, but infections, certain drugs, immune conditions, and malignancies can trigger the development of this condition.…”

“… 5 Approximately 70% of REM cases are caused by the herpes simplex virus (HSV). 1 , 6 In a study involving 37 patients with REM, HSV deoxyribonucleic acid (DNA) was detected in 57% of patients and the rest was idiopathic. 7 Prodromal symptoms are absent in most cases.…”