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[Severe Stevens-Johnson syndrome in 4 children]

L Bott1, C Santos, C Thumerelle

  • 1Service de pédiatrie grand enfant, CHU de Poitiers, 31, rue du clos des cavaliers, 86000 Poitiers, France. lebreton.bott@cegetel.net

Archives De Pediatrie : Organe Officiel De La Societe Francaise De Pediatrie
|November 9, 2007
PubMed

Insights

Severe erythema multiforme in children, often linked to Mycoplasma pneumoniae infection or drugs, can cause serious complications. Early steroid use may offer benefits, but long-term follow-up is crucial.

Area of Science:

  • Pediatric Dermatology
  • Infectious Diseases
  • Allergy and Immunology

Background:

  • Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe mucocutaneous reactions, often part of a spectrum illness with erythema multiforme (EM).
  • EM, SJS, and TEN represent a continuum of disease severity affecting the skin and mucous membranes.

Purpose of the Study:

  • To report on severe cases of erythema multiforme in pediatric patients.
  • To investigate the potential triggers and outcomes of severe EM in children.
  • To evaluate the role of early steroid intervention in managing severe EM.

Main Methods:

  • Retrospective case series of four pediatric patients (ages 6-15) with severe erythema multiforme.
  • Analysis of potential etiologies, including infections and drug exposure.
  • Assessment of clinical course, treatment interventions (including steroid use), and long-term sequelae.

Main Results:

  • Three out of four cases were associated with Mycoplasma pneumoniae infection; one case was linked to drug exposure.
  • Two children experienced severe sequelae, specifically obliterans bronchiolitis.
  • No recurrent disease was observed in the study cohort.

Conclusions:

  • Severe erythema multiforme in children can be triggered by infections like Mycoplasma pneumoniae or by drugs, leading to significant complications.
  • While the use of early steroids in EM is debated, this experience suggests potential overall benefit.
  • Long-term follow-up, including pulmonary function tests, imaging, and dermatological/ophthalmological examinations, is essential for managing patients with severe EM.

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