Herpes simplex virus-associated erythema multiforme in prepubertal children

Area of Science:

• Pediatric Dermatology
• Infectious Diseases
• Viral Infections

Background:

• Erythema multiforme (EM) is an acute, self-limiting hypersensitivity reaction.
• Herpes simplex virus (HSV) is a common trigger for EM, particularly in children.
• Understanding the clinical course and treatment response in prepubertal children is crucial.

Purpose of the Study:

• To investigate the clinical associations of HSV-associated EM in children younger than 13 years.
• To analyze the condition's evolution, recurrence patterns, and treatment outcomes.
• To evaluate the efficacy of acyclovir in treating and preventing EM episodes.

Main Methods:

• Retrospective case series of 12 children under 13 years with EM.
• Evaluation of clinical data including age of onset, preceding illness, and episode duration.
• Assessment of treatment responses to topical/oral acyclovir and prophylactic acyclovir.

Main Results:

• HSV-associated EM occurred in 12 children, with a mean onset age of 8.1 years.
• EM episodes lasted a mean of 10.6 days and were recurrent in 9 children (2.6 episodes/year).
• Oral acyclovir (25 mg/kg/day) did not reduce individual episode duration, but prophylaxis (20 mg/kg/day) prevented recurrences in 3 children.

Conclusions:

• Childhood HSV-associated EM is recurrent, potentially triggered by sun exposure, and does not progress to Stevens-Johnson syndrome.
• Standard acyclovir treatment may be ineffective for individual EM episodes.
• Prophylactic acyclovir can effectively prevent frequent recurrences of EM in susceptible children.