Drug induced mucosal erythema multiforme
Keywords:Erythema multiforme, Fuchs syndrome, Mucosal EM
Erythema multiforme (EM) is a hypersensitivity reaction to different antigenic stimuli, commoner being infection followed by drugs. It occurs predominantly in younger age group. EM has benign course but frequent recurrences are common especially secondary to HSV infection. Erythema multiforme present as classical cutaneous target/ targetoid lesions and mucosal bullae/erosions. Though almost 70% of patients suffer from mucosal involvement, isolated mucosal affection is very rare. Fuchs syndrome/ectodermosis pluriorificialis is a rare variant characterized by severe involvement of two or three mucosal sites in the absence of skin lesions commonly triggered by Mycoplasma pneumoniae. Here we are reporting a rare case of mucosal erythema multiforme secondary to drug and highlighting the importance of distinguishing it from other similarly presenting mucosal disorders.
Scully C, Bagan J. Oral mucosal diseases: Erythema multiforme. British J Oral Maxillofacial Surg. 2008;46(2):90-5.
Farthing P, Bagan JV, Scully C. number Iv Erythema multiforme. Oral Diseases. 2005;11(5):261-7.
Tonnesen MG, Soter NA. Erythema multiforme. Journal of the American Academy of Dermatology. 1979;1(4):357-64.
Taqi SA. Drug-induced oral erythema multiforme: A diagnostic challenge. Annals African Med. 2018;17(1):43.
Wetter DA, Davis MD. Recurrent erythema multiforme: clinical characteristics, etiologic associations, and treatment in a series of 48 patients at Mayo Clinic, 2000 to 2007. J Am Acad Dermatol. 2010;62(1):45-53.
Huff JC, Weston WL, Tonnesen MG. Erythema multiforme: a critical review of characteristics, diagnostic criteria, and causes. J Am Acad Dermatol. 1983;8(6):763-75.
Shah SN, Chauhan GR, Manjunatha BS, DaGruS K. Drug induced erythema multiforme: two case series with review of literature. Journal of clinical and diagnostic research: JCDR. 2014;8(9):ZH01.
Joseph TI, Vargheese G, George D, Sathyan P. Drug induced oral erythema multiforme: A rare and less recognized variant of erythema multiforme. Journal of oral and maxillofacial pathology: JOMFP. 2012;16(1):145.
Power WJ, Ghoraishi M, Merayo-Lloves J, Neves RA, Foster CS. Analysis of the acute ophthalmic manifestations of the erythema multiforme/Stevens-Johnson syndrome/toxic epidermal necrolysis disease spectrum. Ophthalmology. 1995;102(11):1669-76.
Ayangco L. Oral manifestations of erythema multiforme. Dermatologic clinics. 2003;21(1):195-205.