Urethral Complications Due to Erythema Multiforme Major: A Case Report

Erythema multiforme major (EMM) is an acute, immune-mediated mucocutaneous disease that rarely affects the genital mucosal surfaces. This study describes a 39-year-old male with this rare disease and unusual presentation. The patient presented to an emergency department with oral lesions, drainage from both eyes, injected sclera, and characteristic targetoid lesions on the face, upper extremities, torso, and plantar surfaces of the feet. Laboratory results indicated a latent herpes simplex virus type 1 (HSV-1) infection and an active Mycoplasma pneumonia infection. The patient later developed dysuria and sloughing of the urethral mucosa, which was managed conservatively with topical lidocaine and petroleum-impregnated gauze. This treatment resulted in full healing and return of function. Currently, there is limited guidance on treating genital manifestations of EMM. Although this disease is rare, protocols should be developed for the treatment and care of future patients.