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Dermatologic and Ophthalmologic Treatment of Erythema Multiforme Major: A Case Report
Barbara Senger1, Shayan A Memar2, Alex Ahmann2
1Internal Medicine, A.T. Still University, Kirksville College of Osteopathic Medicine, Kirksville, USA.
Cureus
|February 3, 2022
Summary
Erythema multiforme major (EMM) is a rare skin reaction. This case highlights a complex EMM presentation triggered by NSAIDs, HSV-1, and Mycoplasma pneumoniae, requiring multifaceted treatment for recovery.
Area of Science:
- Dermatology
- Infectious Diseases
- Pharmacology
Background:
- Erythema multiforme major (EMM) is a severe mucocutaneous reaction, often triggered by infections or medications.
- Prompt diagnosis and management are crucial to prevent severe complications.
Observation:
- A 39-year-old male presented with EMM affecting skin, oral, ocular, and urethral mucosa.
- The patient had a history of NSAID use, HSV-1 infection, and acute Mycoplasma pneumoniae infection.
- Symptoms included painful lesions impacting feeding and voiding.
Findings:
- A comprehensive treatment approach was employed, including corticosteroids, acyclovir for HSV-1, azithromycin for Mycoplasma pneumoniae, and supportive care.
- Symptomatic treatments included topical agents for oral and urethral discomfort, and fentanyl for pain management.
Implications:
- This case underscores the importance of considering multiple triggers in complex EMM presentations.
- Effective management involves addressing underlying causes and providing targeted symptomatic relief.
- Long-term ophthalmological follow-up is necessary to monitor for sequelae like trichiasis and symblepharon.
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