Characteristics of pediatric recurrent erythema multiforme. Pediatr Dermatol 2018 Jan;35(1):97-103
Date
12/13/2017Pubmed ID
29231254DOI
10.1111/pde.13357Scopus ID
2-s2.0-85040831284 (requires institutional sign-in at Scopus site) 22 CitationsAbstract
BACKGROUND: Erythema multiforme (EM) is an acute condition characterized by distinctive target lesions of the skin often accompanied by mucosal ulcers. A subset of individuals experience frequent episodes of recurrent EM, which is rare and poorly understood, especially in children.
OBJECTIVE: To characterize clinical features, laboratory findings, and treatment responses of pediatric recurrent EM.
METHODS: A retrospective chart review was conducted at the Children's Hospital of Wisconsin in Milwaukee, Wisconsin (2000-2015) and the Mayo Clinic in Rochester, Minnesota (1990-2015). Inclusion criterion was a diagnosis before age 18 years with recurrent EM, defined as a symmetrically distributed, fixed eruption, including target lesions, with or without mucous membrane involvement, occurring on at least three occasions. A literature review was conducted to include individuals who met the inclusion criterion.
RESULTS: Twenty-six patients were included, of whom 16 (62%) were male. The median age of onset was 9.1 years (range 0-15.7 years). Nine patients (35%) required hospitalization. Herpes simplex virus testing was positive in 9 of 17 (65%) patients. Remission was achieved in 5 of 16 (31%) patients while taking suppressive antivirals. Eight patients received continuous anti-inflammatory treatment, two (25%) of whom experienced remission.
CONCLUSION: This study of pediatric recurrent EM found a greater male predominance, more hospitalizations, fewer cases caused by herpes simplex virus, and a lower response to immunosuppression in children than in the general population.
Author List
Heinze A, Tollefson M, Holland KE, Chiu YEAuthors
Yvonne E. Chiu MD Vice Chair, Professor in the Dermatology department at Medical College of WisconsinKristen E. Holland MD Associate Professor in the Dermatology department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdolescentAnti-Infective Agents
Child
Child, Preschool
Cohort Studies
Erythema Multiforme
Female
Humans
Immunosuppressive Agents
Infant
Male
Minnesota
Recurrence
Retrospective Studies
Treatment Outcome
Wisconsin
