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Recurrent erythema multiforme: A therapeutic proposal for a chronic disease
Natasha Favoretto Dias de Oliveira1, Denise Miyamoto1, Celina Wakisaka Maruta1
1Department of Dermatology, University of São Paulo Medical School, Sao Paulo, Brazil.
The Journal of Dermatology
|July 5, 2021
Summary
Recurrent erythema multiforme, a chronic skin condition, often responds well to acyclovir treatment. Combined therapies with dapsone or thalidomide may be necessary for persistent cases, guiding long-term management.
Area of Science:
- Dermatology
- Infectious Diseases
- Clinical Medicine
Background:
- Recurrent erythema multiforme (EM) is a challenging chronic relapsing skin condition.
- Identifying effective therapeutic strategies is crucial for patient management.
Purpose of the Study:
- To retrospectively evaluate clinical-epidemiological features of recurrent EM.
- To assess therapeutic responses and propose a management protocol.
Main Methods:
- Retrospective analysis of 35 patients diagnosed with recurrent EM (2000-2019).
- Inclusion criteria: clinical symptoms and positive herpes simplex virus (HSV) serology.
- Treatment initiated with acyclovir, with additions of dapsone, thalidomide, or immunosuppressants for refractory cases.
Main Results:
- The majority of patients (71.4%) were female, with a median onset age of 35.7 years.
- HSV IgG serology was positive in 91.1% of cases.
- Acyclovir achieved initial remission in 22/33 patients; 16 relapsed. Combined therapy was required for some, with thalidomide used for dapsone adverse effects.
Conclusions:
- Recurrent EM shows good response to acyclovir monotherapy or combined therapy (dapsone, thalidomide).
- A long-term therapeutic protocol is proposed to achieve sustained disease remission.
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