SEARCH · Search PubMed

Results for “Erythema Multiforme”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

SourceResearch connectionFrom yearThrough year

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,495 records · Page 83Linked to original sources

PubMed2005

Acute glomerulonephritis associated with streptococcus pyogenes with concomitant spread of streptococcus constellatus in four rural families.

We studied history, renal histopathology and microbiology of an epidemic of acute glomerulonephritis associated with throat infections and uncommon culture results in four neighbour families. A 40-year-old man (index patient) was referred to a university hospital for dialysis and kidney biopsy due to a suspected acute glomerulonephritis. An acute tonsillitis had preceded the condition. Penicillin treatment had been started four days before the discovery of renal failure. Throat swabs were positive for beta-hemolytic streptococci, group C (GCS). GCS were also found in throat cultures from his wife and two of their children. The bacteria were typed as Streptococcus constellatus. A third child had S. constellatus expressing Lancefield antigen group G. A neighbour and two of his children fell ill the following week with renal involvement. Throat swabs from both these children were positive for S. constellatus. His third child had erythema multiforme and S. constellatus in the throat while a fourth child had beta-hemolytic streptococci group A; Streptococcus pyogenes. Kidney biopsies on the index patient and his neighbour showed an acute diffuse prolipherative glomerulonephritis compatible with acute post-streptococcal nephritis and microbiological analysis of renal tissue revealed in both cases S. pyogenes and S. constellatus. The families had had much contact and had consumed unpasteurized milk from our index patient's farm. In four of seven persons in two additional neighbouring families S. constellatus was found in throat swabs during the same month while two persons carried Streptococcus anginosus expressing the Lancefield C antigen. In conclusion spread of S. constellatus coincided with the occurrence of four cases of acute glomerulonephritis. The two biopsied patients had both S. pyogenes and S. constellatus present in renal tissue. The epidemic either suggested that the outbreak of glomerulonephritis was due to S. pyogenes but coincided with the transmission and colonization of S. constellatus or that the S. constellatus strains were highly pathogenic or nephritogenic and that this organism can be transmitted in such cases.

Acute Disease↗

PubMed1995

Chronic hepatitis C and skin diseases: a review.

OBJECTIVE: To emphasize the ongoing role of chronic hepatitis C virus (HCV) infection in the cause or exacerbation of severe dermatologic disorders. DESIGN: We present two case reports to outline the pertinent findings in hepatitis C-related cryoglobulinemia, leukocytoclastic vasculitis, and lichen planus and discuss the main disorders associated with chronic HCV infection. RESULTS: Chronic HCV infection has recently been recognized in association with various skin disorders. The most commonly reported association is the triad of leukocytoclastic vasculitis, cryoglobulinemia, and chronic HCV infection. Other cutaneous disorders associated with HCV infection include porphyria cutanea tarda, lichen planus, erythema nodosum, urticaria, erythema multiforme, and polyarteritis nodosa. CONCLUSION: Patients with onset or exacerbation of these disorders should undergo assessment for HCV infection.

Adult↗

PubMed2004

Papular spongiotic dermatitis of smallpox vaccination: report of 2 cases with review of the literature.

We report 2 cases of nonspecific postvaccinial dermatitis following smallpox vaccination. The patients presented with diffuse, pruritic, erythematous macules and papules 11 days (case 1) and 7 days (case 2) following routine smallpox vaccination. Biopsies of the lesions demonstrated spongiotic dermatitis without evidence of viral cytopathic changes. One case showed a pityriasis rosea-like histologic pattern. The exanthema resolved without sequelae with symptomatic treatment (case 1). Review of historical literature demonstrated the association of a variety of nonspecific cutaneous complications with vaccinia inoculation, including erythema multiforme, urticaria, and pityriasis rosea. The association of these various dermatitides with smallpox immunization is not well known and is likely underreported.

Adult↗

PubMed1987

Use of pyrimethamine-sulfadoxine (Fansidar) in prophylaxis against chloroquine-resistant Plasmodium falciparum and Pneumocystis carinii.

The widespread emergence of chloroquine-resistant Plasmodium falciparum led to the formulation of an effective, fixed combination of two antimalarial agents, pyrimethamine and the long-acting sulfonamide sulfadoxine, for prophylaxis and treatment. These drugs act at sequential steps to inhibit the formation of tetrahydrofolate in the parasite. Recently, their use for malaria prophylaxis has been associated with severe, at times fatal, cutaneous reactions including erythema multiforme, Stevens-Johnson syndrome, and toxic epidermal necrolysis. These reactions have necessitated a major reassessment of the indications for pyrimethamine-sulfadoxine use and increased the search for pharmacologic, immunologic and behavioral approaches to the prophylaxis and treatment of infection with P. falciparum. Pyrimethamine-sulfadoxine may be effective in preventing recurrent pneumonia caused by Pneumocystis carinii in patients with the acquired immunodeficiency syndrome, but life-threatening cutaneous reactions have also been reported in this setting.

Acquired Immunodeficiency Syndrome↗

PubMed1999

The association of opportunistic infections with the occurrence of trimethoprim/sulfamethoxazole hypersensitivity in patients infected with human immunodeficiency virus.

Hypersensitivity from trimethoprim/sulfamethoxazole (TMP/SMX) has been linked to a reactive nitroso intermediate from sulfamethoxazole metabolism, which may be altered in patients with human immunodeficiency virus (HIV) infection. The authors determined the clinical factors that are associated with TMP/SMX hypersensitivity in patients with HIV. In a case control study, 54 controls currently tolerating TMP/SMX prophylaxis were randomly matched by date of hypersensitivity reaction in case patients to 28 patients with a history of a rash consistent with erythema multiforme from TMP/SMX. Demographic data, coadministered medications, laboratory data, and histories of opportunistic infections were extracted on all patients. A highly significant association was observed between the number of opportunistic infections and the occurrence of TMP/SMX hypersensitivity (p < 0.001), despite comparability of CD4 counts between case patients and controls (p > 0.1). A tendency for protection from TMP/SMX hypersensitivity in blacks was also observed (p = 0.066). These observations suggest that the mechanisms by which HIV produces cellular immune dysfunction and alters drug detoxification may be linked.

AIDS-Related Opportunistic Infections↗

PubMed1999

Stevens-Johnson syndrome. Description of an unusual clinical case due to glucocorticoid therapy for oral lichen planus.

Erythema multiforme (EM) is an acute inflammatory disease with an autoimmune pathogenesis clinically expressing in a wide variety of mucocutaneous illnesses. It is usually described in a minor form (Von Hebra) characterized by classical cutaneous lesions, and in major form (Stevens-Johnson), involving mucosal damage, while a clinical type restricted to the oral mucosa is described in oral pathology. A considerable number of factors of different nature have been reported as etiologic agents of EM, but most of them are not well documented; however, a certain relationship with EM is recognized for different classes of systemic drugs. This paper describes a case of Stevens-Johnson syndrome with initial oral involvement, in which the precipitating factor was due to the administration of systemic glucocorticoids, prescribed for the therapeutic treatment of an erosive form of oral lichen planus.

Aged↗

PubMed1979

[Acute enteritis with "new" pathogens. Yersinia infections (author's transl)].

Infections of the intestinal tract with Yersinia enterocolitica and Yersinia pseudotuberculosis are known the world over. Post-infection reactions like arthritis, erythema nodosum, erythema multiforme, scarlatiniform exanthemata and septicemic types deserve particular clinical attention. The clinical importance of enteric yersinioses has been shown in studies with the identification of significant antibody titers against Yersinia enterocolitis and Yersinia pseudotuberculosis in 6.71 and 4.58% respectively of 4411 patients examined for the first time. It was possible to isolate Yersinia enterocolitica from 5.05% of 616 samples of stool and Yersinia pseudotubercolosis from 0.66% of 136 lymph nodes taken from 751 patients.

Abdomen, Acute↗

PubMed1999

A review of common mucocutaneous disorders affecting the mouth and lips.

Most oral involvement in the mucocutaneous diseases is related mainly to disorders with a prominent immunological component, especially lichen planus and pemphigoid. However, less common conditions such as pemphigus, dermatitis herpetiformis, linear IgA disease, erythema multiforme, chronic ulcerative stomatitis and other conditions may need to be excluded. Diagnosis is initially clinical, based on a full history, general, and oral examination but precise diagnosis can be difficult without further data and therefore biopsy and immunological studies are invariably required to confirm the specific diagnosis. Apart from improving oral hygiene, immunosuppressive therapy is typically required to control many of these conditions.

Humans↗

PubMed2000

Multiple antibiotic sensitivity syndrome in children.

BACKGROUND: Multiple antibiotic sensitivity syndrome with adverse drug reactions to multiple classes of antibiotics has been described in adults but is not well characterized in children. PATIENTS AND METHODS: Charts of children referred to the adverse drug reaction clinic at the Children's Hospital of Western Ontario, London, Ontario, with adverse drug reactions to multiple antibiotics were reviewed to determine the number of patients with adverse drug reactions to multiple classes of antibiotics and the clinical characteristics of the adverse events. RESULTS: The records of 97 children who were selected as possible candidates for multiple antibiotic sensitivity were studied. These records constituted 11% of referrals to a highly specialized adverse drug reaction clinic, suggesting that in usual clinical practice, this entity, if it does indeed constitute a distinct clinical entity, is quite uncommon. Age at time of the first adverse drug reaction was 26.1+/-26.3 (mean +/- SD) months. Among the 97 children, adverse reactions to five classes of antibiotic were noted in 3.1%, to four in 10.3%, to three in 47. 4% and to two in 39.2%. Most children (85.6%) experienced an adverse reaction to a penicillin, while 71.1% reacted to a cephalosporin, 80. 4% to a sulphonamide and 35.1% to a macrolide. Clinical presentations of the adverse reactions included urticaria or pruritus, other rash, serum sickness-like reaction, angioedema or anaphylaxis, erythema multiforme or Stevens-Johnson syndrome. CONCLUSIONS: There are children who have what appears to be immunologically mediated adverse drug reactions to antibiotics of multiple classes. These reactions, which most commonly manifest as urticaria or other rashes, follow drug use patterns. It remains to be defined whether this is a distinct clinical syndrome or a manifestation of a more fundamental problem in dealing with xenobiotics in the setting of infection. Further work on the immunological and/or biochemical determinants of the multiple antibiotic sensitivity syndrome (MASS) is needed to understand the pathophysiology and determinants of MASS and whether MASS constitutes a distinct clinical entity.

Anti-Bacterial Agents↗

PubMed2000

Stevens-Johnson syndrome after erythromycin therapy while deployed at sea.

Stevens-Johnson syndrome is a cutaneous reaction pattern that represents the progression of symptoms of erythema multiforme. These reactions can range from mild (EM minor) to severe (EM major) and even life-threatening (Stevens-Johnson syndrome or toxic epidermal necrolysis). The difference between Stevens-Johnson syndrome and toxic epidermal necrolysis is the percentage of body surface area involved; toxic epidermal necrolysis involves widespread skin necrosis and bullous formation with epidermal detachment resembling scalded skin. The three most common triggers for Stevens-Johnson syndrome are herpes simplex infection, Mycoplasma infection, and drug reactions. This is a case of Stevens-Johnson syndrome occurring after erythromycin treatment aboard an aircraft carrier while deployed at sea in the Persian Gulf.

Adult↗

PubMedDate not supplied

[Skin diseases and hepatitis virus C infection].

INTRODUCTION: Using a creative molecularbiologic technique in 1989 Choo and co-workers isolated a new virus of hepatitis C, an agent responsible for numerous cases of parenterally transmissible viral hepatitis. Hepatitis C virus is a RNA virus with unique genomic organisation. Six genotypes of hepatitis C virus have been identified, which differ in geographical distribution, tendency towards chronicity and sensitivity to antiviral therapy. Transmission occurs due to apparent and inapparent parenteral procedures (after transfusion, transplantation, transplacentally, during lactation, sexually or after accidental injury of medical staff). Mode of transmission through intact skin or mucosa has not been proved yet. Due to development of laboratory methods for detection of anti-hepatitis C virus antibodies and obligation for routine testing of blood donors for hepatitis C in majority of countries in the world, risk of post-transfusion hepatitis C is minimised to less than 1%. In 70% of patients the infection runs a chronic course, affecting numerous extrahepatic organ systems, including skin. VASCULITIS ASSOCIATED WITH MIXED ESSENTIAL CRYOGLOBULINEMIA: Mixed essential cryoglobulinemia is a disorder with deposition of circulating immune complexes in small and medium blood vessels. Clinical characteristics comprise palpable purpura on lower extremities, arthralgias and weakness. It might occur during autoimmune disorders, liver diseases and viral infections, among which hepatitis C infection has a central part. Mixed cryoglobulins can be detected in 35-54% of patients with hepatitis C and symptomatic vasculitis associated cryoglobulinemia, decreased C4 component of complement, positive rheumatoid factor and elevation of hepatic enzymes occurs in 10-21% of patients. Findings of anti-hepatic C virus antibodies and/or viral RNA in 96% of patients with mixed cryoglobulinemia can be considered as a definitive proof of etiopathogenetic association between hepatitis C infection and mixed cryoglobulinemia. Interferon alpha therapy is a first-choice therapy, although transient responses are frequent. PORPHYRIA CUTANEA TARDA: Hepatitis C infection has recently been recognised as an important precipitating factor of clinical porphyria cutanea tarda sympotomatology. Apart from high level of seropositivity among porphyria cutanea tarda patients (62-100%), association between these two entities hasn't been clearly revealed yet. The question whether hepatitis C infection is enough to be the only precipitating factor, or other hepatotoxic cofactors are necessary, still exits. Interferon therapy has been a meter of several studies, but no definite recommendations had been given about its administration in these cases. LICHEN PLANUS: About possible association between lichen planus and chronic liver diseases, and hepatitis C infection as well, suggest 35% prevalence of hepatic disorders in patients with lichen planus, and 9.8-23% of hepatitis C virus seropositivity. The clinical picture of lichen planus in hepatitis C virus infection is characterised by generalised skin lesions, with erosive involvement of oral mucous membrane, and by chronic course. Therapeutical efficiency of interferon is unpredictable, with possible improvement, cure or deterioration of lichen planus. OTHER DERMATOLOGICAL DISORDERS: Other dermatological disorders (erythema nodosum, erythema multiforme, urticaria) may be direct consequences of hepatitis C infection, of other extrahepaic non-dermatological manifestations, or fortuitous reports. CONCLUSION: Considering big pathogenetic potentials of hepatitis C virus with possible skin involvement, and proved association between cutaneous necrotising vasculitis with mixed essential cryoglobulinemia, porphyria cutanea tarda, lichen planus and chronic hepatitis C infection, all patients with these disorders should be tested for hepatitis C and all cases of hepatitis C should be searched for signs and symptoms of these skin diseases.

Hepatitis C↗

PubMedDate not supplied

[Cutaneous manifestations of Yersinia enterocolitica infection].

BACKGROUND: Cutaneous manifestations occurring in infections due to Yersinia enterocolitica are usually erythema nodosum, erythema multiforme or cutaneous vasculitis. The association between Yersinia infection and Sweet's syndrome is rare. We describe such a case contributing to the discussion on this association. CASE-REPORT: A 29-year-old woman had a papulo-pustular eruption with fever associated with arthralgia. The results of the infectious laboratory investigations were negative but Yersinia enterocolitica type 0.9 was isolated from a stool culture. The serologic diagnosis of Yersinia enterocolitica using serum agglutinins was negative. The diagnosis of Sweet's syndrome was made on a skin biopsy specimen. Search for hematology disease or underlying neoplasia was negative. The clinical course was rapidly favorable with antibiotic treatment (ciprofloxacin). DISCUSSION: The diagnosis of Yersinia enterocolitica infection is difficult. Microbiologic diagnosis of Yersinia infection is best achieved by isolation of the bacterium from a clinical specimen of involved tissue. The agglutination test is not highly specific or sensitive. Immunoblotting appears to be more sensitive.

Adult↗

PubMed2000

[Stomatitis in childhood, not always benign].

Two boys of 1 and 16 year had painful buccal lesions and were admitted for dehydration. The younger had finger and toe blisters; the older, severely ill, had conjunctivitis, urethritis and skin lesions. Only symptomatic treatment with lidocaine gel and paracetamol gave good recovery. A 5-year-old Turkish girl had recurrent painful buccal ulcers which each time cleared up spontaneously. Stomatitis is common in childhood. Viral infections are the most common causes of stomatitis, in particular infections with herpes simplex virus (herpes gingivostomatitis), Coxsackie virus (herpangina, hand-foot-mouth-disease), chickenpox and infectious mononucleosis. Bacterial infections are rare and mostly secondary to the viral infections. In infants oral candidiasis (thrush) is a common cause of stomatitis. Most infections are self-limiting and reassurance of parents is important. Dehydration is a common complication and admission to hospital can be prevented by analgesics. The most important non-infectious conditions that cause stomatitis in children are recurrent aphthous stomatitis, erythema multiforme major (Stevens-Johnson syndrome), Behçet's disease, malignancy (leukaemia), immune-mediated disorders (agranulocytosis, cyclic neutropenia), traumata, blistering disorders of the skin and lichen planus. A complete history and a thorough physical examination usually give the correct diagnosis and further investigations are seldom necessary.

Adolescent↗

PubMed2001

Ibuprofen-induced bullous leukocytoclastic vasculitis.

A dramatic case of ibuprofen-induced bullous leukocytoclastic vasculitis (LCV) is described in a patient with a history of prior sensitization to ibuprofen, a common household nonsteroidal anti-inflammatory drug (NSAID) that has few reported adverse skin reactions. Bullous LCV is a relatively rare clinical presentation of LCV, which requires differentiation from other blistering diseases, including bullous erythema multiforme, bullous fixed drug eruption, linear IgA bullous dermatosis, and bullous pemphigoid. The distinctive histopathologic changes of leukocytoclastic vasculitis readily distinguish this bullous eruption from the others.

Aged↗

PubMed2001

Kissing bugs (Triatoma) and the skin.

Kissing bugs (Family Reduviidae) can be the source of nocturnal dermatologic wounds in the mid to southern latitudes in the United States. The insects are obligate blood feeders and though the bites may be asymptomatic, a variety of dermatologic eruptions or death from anaphylaxis can result. The various dermatologic forms of the bite can be mistaken for herpes zoster, erythema multiforme and the ubiquitous catch-all diagnoses of "spider-bite."

Animals↗

PubMed2001

Pesticides as a cause of occupational skin diseases in farmers.

Pesticides are chemical substances used in agricultural production to protect crops against pests. They help to achieve better quality and quantity of crops; however, they also are capable of causing occupational diseases in farmers. Skin is the most exposed organ while spraying the pesticide on fields. Farmers are also exposed to pesticides while mixing, loading the pesticide as well as while cleaning the equipment and disposing of empty containers. Other activities associated with exposure are sowing pesticide-preserved seeds, weeding and harvesting previously sprayed crops. During the first decades of using pesticides the main problem was the risk of acute intoxication among people occupationally exposed. With decrease in the toxicity of improved pesticides, attention was turned to chronic intoxication and environmental contamination. Nowadays, the problem of diseases not immediately related to the toxic potential of pesticides gains increasing interest. The majority of these non-toxic diseases are dermatoses. Most pesticide-related dermatoses are contact dermatitis, both allergic or irritant. Rare clinical forms also occur, including urticaria, erythema multiforme, ashy dermatosis, parakeratosis variegata, porphyria cutanea tarda, chloracne, skin hypopigmentation, nail and hair disorders. Farmers exposed to arsenic pesticides are at risk of occupational skin cancer, mostly morbus Bowen (carcinoma in situ), multiple basal cell carcinomas and squamous cell carcinomas. Non-arsenic pesticides, e.g. paraquat, are also potentially carcinogenic.

Agricultural Workers' Diseases↗

PubMed2001

Cutaneous reactions to anticonvulsant medications.

Skin eruptions are an important consideration for any clinician who prescribes anticonvulsant medications. The timely recognition and accurate diagnosis of cutaneous reactions can prevent potentially fatal reactions and affect subsequent anticonvulsant treatment options. This review addresses the most common and most serious cutaneous reactions to anticonvulsant medications. The anticonvulsant hypersensitivity syndrome and individual antiepileptic medications that cause severe skin reactions will be reviewed. These reactions include morbilliform and urticarial drug eruptions as well as the erythema multiforme spectrum.

Anticonvulsants↗

PubMed2001

[Metastatic Crohn's disease in childhood].

Crohn's disease (CD) is an intestinal inflammatory disease of unknown origin that is sometimes associated with cutaneous manifestations. These skin lesions are usually nonspecific (erythema nodosum, erythema multiforme and pyoderma gangrenosum) and should be differentiated from the cutaneous lesions corresponding to the typical histological pattern of CD; most of these extend directly from the involved bowel. Noncaseating granulomatous infiltration in skin anatomically distant from areas of gastrointestinal CD and separated by normal skin is extremely rare. This entity, known as metastatic Crohn's disease, can be the first symptom of CD or even more unusually can appear during the course of the disease.We report the case of a 9-year-old boy, previously diagnosed with ileocolic and perianal CD, who had been receiving treatment with mesalazine, prednisone and 6-mercaptopurine for 3 years. He presented with swelling of the penis and scrotum of 2 weeks' evolution, without any other symptoms. Testicular ultrasound showed thickening of the scrotal wall and increased flux at this site. Skin biopsy showed noncaseating granulomas. Results of special staining techniques were negative for the presence of microorganisms. The prednisone dose was increased and metronidazole was added, with noticeable improvement in the lesions. Due to reappearance of cutaneous lesions when the prednisone dose was reduced, the patient currently receives maintenance treatment.

Anal Canal↗