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Persistent erythema multiforme: a report of three cases
M D Pavlović1, D M Karadaglić, L O Kandolf
1Department of Dermatovenereology, Military Medical Academy, Belgrade, Yugoslavia.
Abstract:
Three cases of persistent erythema multiforme, two of unknown aetiology and one precipitated by influenza are reported. Lesions were widespread, mostly atypical in appearance and regressed in response to immunosuppressants (systemic steroids and/or azathioprine) or, in one case, to dapsone. One patient developed erythroderma responding eventually to etretinate. Histology in all patients was consistent with the mixed, epidermodermal pattern of erythema multiforme. There were no significant laboratory abnormalities nor marked symptomatology apart from itching. The persistent form appears to belong to the spectrum of erythema multiforme being heterogeneous with respect to inducing stimuli, including viral antigens, neoplastic or inflammatory disease or unknown causes. Whenever it is possible, treatment should be adjusted depending on the causative agent.
Insights
Persistent erythema multiforme, a rare skin condition, can present with atypical lesions and respond to immunosuppressants or dapsone. Treatment adjustment based on the cause is recommended for this heterogeneous condition.
Area of Science:
- Dermatology
- Immunology
Background:
- Persistent erythema multiforme is a rare dermatological condition.
- Etiologies can include viral infections, neoplastic diseases, or unknown factors.
Observation:
- Three cases of persistent erythema multiforme are presented.
- Lesions were widespread and atypical.
- One case was linked to influenza.
Findings:
- Lesions regressed with immunosuppressants (steroids, azathioprine), dapsone, or etretinate.
- Histology confirmed a mixed, epidermodermal pattern.
- No significant laboratory abnormalities or severe symptoms were noted, apart from itching.
Implications:
- Persistent erythema multiforme is a heterogeneous condition within the broader spectrum of erythema multiforme.
- Treatment strategies should be tailored to the specific causative agent when identifiable.