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Clinicopathologic correlation in erythema multiforme and Stevens-Johnson syndrome
B Côté1, J Wechsler, S Bastuji-Garin
1Department of Dermatology, Hôpital Henri-Mondor, Université Paris XII, Créteil, France.
Archives of Dermatology
|November 1, 1995
Summary
Histopathology distinguishes severe erythema multiforme (EM) from Stevens-Johnson syndrome. Distinct inflammatory and necrotic patterns in skin biopsies correlate with these distinct disorders, aiding diagnosis.
Area of Science:
- Dermatopathology
- Clinical Dermatology
Background:
- Severe erythema multiforme (EM) spectrum may represent distinct disorders.
- Retrospective analysis of 38 severe EM cases was performed.
Purpose of the Study:
- To confirm if severe EM comprises two distinct disorders based on histopathology.
- To correlate histopathologic features with clinical presentations of EM major and Stevens-Johnson syndrome.
Main Methods:
- Retrospective study of 38 severe EM cases.
- Classification based on clinical presentation: EM major vs. Stevens-Johnson syndrome.
- Histopathologic analysis of biopsy specimens, focusing on epidermal and dermal changes.
Main Results:
- Two distinct histopathologic patterns identified: predominantly inflammatory (EM major) and predominantly necrotic (Stevens-Johnson syndrome).
- EM major showed less epidermal necrosis, more dermal inflammation, and more exocytosis.
- Stevens-Johnson syndrome exhibited more epidermal necrosis, less dermal inflammation, and less exocytosis, with significant differences noted.
Conclusions:
- Severe EM symptomatologies correlate with distinct histopathologic patterns.
- Findings support EM major and Stevens-Johnson syndrome as separate entities.
- Further prospective multicenter studies are recommended for definitive characterization.