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Erythema Multiforme in Children and Mycoplasma pneumoniae Aetiology

Annie Langley1, Niloofar Anooshiravani1, Sarah Kwan1

  • 1The Hospital for Sick Children, Toronto, ON, Canada.

Journal of Cutaneous Medicine and Surgery
|March 16, 2016
PubMed

Insights

Mycoplasma pneumoniae is frequently linked to Erythema Multiforme Major (EMM) in children, unlike Stevens-Johnson Syndrome (SJS). Early suspicion of M. pneumoniae is crucial for patients with atypical target lesions and central blistering.

Area of Science:

  • Pediatric Dermatology
  • Infectious Diseases
  • Clinical Immunology

Background:

  • Erythema multiforme (EM) in children is often misdiagnosed as Stevens-Johnson syndrome (SJS).
  • Distinct etiologies and clinical presentations differentiate EM and SJS.
  • The role of Mycoplasma pneumoniae in pediatric EM requires further investigation.

Purpose of the Study:

  • To investigate the prevalence of Mycoplasma pneumoniae in pediatric patients diagnosed with EM minor, EM major (EMM), and SJS.
  • To differentiate the etiological associations between EM subtypes and SJS.

Main Methods:

  • Retrospective cohort study at The Hospital for Sick Children (1999-2013).
  • Inclusion of all pediatric cases of EM minor, EMM, and SJS.
  • Analysis of etiological factors, including infectious and drug-related causes.

Main Results:

  • Mycoplasma pneumoniae was identified in 61% of EMM cases, significantly higher than in SJS (14%) and EM minor (22%).
  • M. pneumoniae-positive patients were older and more likely to present with sore throat and atypical target lesions with central blistering.
  • Infections accounted for 79% of attributed etiologies, with M. pneumoniae being a prominent factor in EMM.

Conclusions:

  • Mycoplasma pneumoniae is a significant etiological factor in pediatric Erythema Multiforme Major.
  • Clinical presentation of atypical target lesions with central blistering in children warrants suspicion for M. pneumoniae.
  • Prompt consideration and treatment of M. pneumoniae are recommended in suspected cases pending laboratory confirmation.
Keywords:
Mycoplasma pneumoniaeerythema multiformepaediatric dermatology

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