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Interventions for erythema multiforme: a systematic review.

T de Risi-Pugliese1,2, E Sbidian1,3,4, S Ingen-Housz-Oro1,3

  • 1Service de Dermatologie, AP-HP, Hôpital Henri Mondor, Créteil, France.

Journal of the European Academy of Dermatology and Venereology : JEADV
|January 26, 2019
PubMed
Summary
This summary is machine-generated.

This systematic review found limited evidence for erythema multiforme (EM) treatments. Continuous acyclovir showed promise for recurrent EM, while thalidomide warrants further investigation for flare duration.

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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.