Interventions for erythema multiforme: a systematic review

Area of Science:

• Dermatology
• Systematic Reviews
• Evidence-Based Medicine

Background:

• Erythema multiforme (EM) treatment lacks standardized protocols.
• Acute and chronic EM forms require effective therapeutic strategies.
• Systematic reviews are crucial for evaluating EM management options.

Purpose of the Study:

• To systematically review topical and systemic treatments for acute and chronic erythema multiforme (EM).
• To assess treatment effects on healing time and episode frequency in adult EM patients.
• To identify evidence gaps and guide future research in EM management.

Main Methods:

• Systematic review of randomized controlled trials (RCTs), observational studies, and case series (n ≥ 10).
• Searched four databases (MEDLINE, CENTRAL, EMBASE, LILACS) up to March 20, 2018.
• Included studies focused on EM treatment efficacy and outcomes, excluding isolated mucosal EM.

Main Results:

• One RCT (n=20) indicated continuous acyclovir significantly improved EM remission compared to placebo over 6 months.
• A case series (n=20) suggested thalidomide reduced recurrent EM flare duration (5.1 vs. 16.2 days).
• Adverse event reporting and quality of life assessments were inadequate in the included studies.

Conclusions:

• Low-level evidence supports continuous acyclovir for recurrent EM.
• Thalidomide shows potential for recurrent EM, meriting further research.
• Insufficient safety data exists for current EM treatments, necessitating more rigorous studies.