Multiforme skin lesions in Yekatit 12 Hospital, 1976-1994

Because the number of cases of multiforme skin lesions encountered in the medical department of Yekatit 12 Hospital has increased in recent years, we conducted a retrospective study to identify the likely precipitating factors and the possible relationship of these with HIV infection. Forty-seven patients with Multiforme Skin Lesions (29 males, 18 females) were admitted between 1976 and January 1994, of whom 43 (92%) were admitted in the past 5 years. Most patients were aged 15-49 years. Thirty patients (64%) were discharged improved and 14 (30%) expired in hospital. The outcome of 3 patients are not known. The charts of only 16 patients could be retrieved for review. Fifteen of these (94%) gave a history of intake of streptomycin, isoniazed and thiacetazone prior to developing the skin manifestation. The anti-TB medications were discontinued initially; 14 patients were restarted on STM, INH and ethambutol without recurrence of the rash. All but 1 were discharged improved. HIV screening tests were done on 24 patients with multiforme skin lesion of whom 21 (88%) were seropositive. Our study suggested that the adverse effects of thiacetazone are increased in HIV associated tuberculous patients. We recommend that further studies be conducted in HIV seropositive and seronegative patients.