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Related Experiment Videos

Recurrent erythema multiforme.

J C Huff1, W L Weston

  • 1Department of Dermatology, University of Colorado School of Medicine, Denver 80262.

Medicine
|May 1, 1989
PubMed
Summary
This summary is machine-generated.

Recurrent erythema multiforme (EM) is strongly linked to herpes simplex virus (HSV) infections. This study found compelling evidence of HSV in patients with repeated EM episodes, particularly in skin biopsies.

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Area of Science:

  • Dermatology
  • Virology
  • Immunology

Background:

  • Erythema multiforme (EM) is an acute, self-limiting condition often associated with infections.
  • Recurrent EM (rEM) presents unique challenges in diagnosis and management.
  • The specific triggers and pathogenesis of rEM remain incompletely understood.

Purpose of the Study:

  • To investigate the association between herpes simplex virus (HSV) and recurrent erythema multiforme (rEM).
  • To characterize clinical features and lesion patterns in patients with rEM.
  • To explore diagnostic markers for HSV in rEM.

Main Methods:

  • Prospective clinical study of 22 patients with recurrent EM.
  • Clinical evaluation including lesion count, location, and history of preceding infections.

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  • Serological testing for HSV antibodies (enzyme immunoassay).
  • Viral cultures for HSV from throat and EM lesions.
  • Indirect immunofluorescence staining of EM skin biopsies for HSV glycoprotein gB.
  • Main Results:

    • All 22 rEM patients had a history of preceding HSV infections.
    • HSV antibodies were detected in all study subjects.
    • No HSV was isolated from throat or EM lesions during active episodes.
    • Positive HSV viral cultures were obtained from suspected recurrent herpes lesions in 11 patients.
    • EM skin biopsies showed positive staining for HSV glycoprotein gB in keratinocytes.
    • The isomorphic phenomenon was observed in 19/22 patients, photodistribution in 15/22.

    Conclusions:

    • There is compelling evidence for a strong association between herpes simplex virus and recurrent erythema multiforme.
    • Recurrent EM pathogenesis likely involves HSV reactivation, although direct viral detection in EM lesions can be challenging.
    • Clinical features like the isomorphic phenomenon and photodistribution are common in rEM.
    • HSV glycoprotein gB detection in keratinocytes suggests direct viral involvement in EM lesions.