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Results for “Erythema Multiforme”

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PubMed1988

Vulvovaginal sequelae of Stevens-Johnson syndrome and their management.

We describe a woman with Stevens-Johnson syndrome, a life-threatening form of erythema multiforme characterized by bullae formation, extensive mucosal damage, and systemic toxicity, and known to be triggered by various drugs, infections, ingestants, or contactants. Serious complications have been reported in most body systems, including cases of permanent damage to the urogenital tract. Three methods of surgical treatment for severe vaginal complications, depending on the degree of vaginal mucosal damage, are described, including the successful treatment of our patient, who had vaginal adenosis, endometriosis, and severe stenosis from this disease. Methods of therapy are presented for possible prevention of severe vaginal sequelae from Stevens-Johnson syndrome.

Adult↗
PubMed1987

The role of oral acyclovir in the management of genital herpes simplex.

Oral acyclovir is an antiviral nucleoside analogue that has recently been released in Canada for use in selected patients with genital infections by the herpes simplex virus. First episodes of genital herpes should be treated with oral acyclovir as soon as the diagnosis is considered. Most people with recurrent genital herpes do not require systemic drug therapy. Selected patients with severe or long-lasting recurrences, recurrences associated with long prodromal periods (greater than 12 to 24 hours) or systemic complications such as erythema multiforme and eczema herpeticum may receive measurable benefit from treatment at the onset of symptoms. In most patients frequently recurrent disease can be suppressed with long-term therapy. Since long-term safety beyond 1 year has not been established, suppressive therapy should be stopped at least once per year to reassess the recurrence pattern. Acyclovir has not been adequately tested for safety in pregnancy and should not be prescribed for pregnant women unless the potential benefits outweigh the risks. Careful attention to disease severity, accurate diagnosis and exclusion of other causes of genital lesions will ensure that the drug is used only when beneficial.

Acyclovir↗
PubMed1987

Stevens-Johnson syndrome associated with Mycoplasma pneumoniae infection.

The Stevens-Johnson syndrome is a relatively uncommon, severe form of erythema multiforme. A case is presented in which Mycoplasma pneumoniae infection was established as the causative agent. Clinicians need to be aware of this uncommon association. We emphasize the need to consider M. pneumoniae infection as one of the many agents responsible for the Stevens-Johnson syndrome.

Adolescent↗
PubMed1987

[ARDS in Mycoplasma pneumonia].

In this paper we describe a case of bilateral broncho-pneumonia due to invasion by mycoplasma pneumoniae, leading to ARDS. A high serum level of cold agglutinins, a mild haemolysis and a rash resembling that of an erythema multiforme were noted. The initial treatment was non-specific. After pathogen identification tetracycline therapy was initiated. Bacterial superinfections were treated with appropriate antibiotic schemas. The observed biphasic clinical course could be explained as an immunological phenomenon.

Adult↗
PubMed1987

Clinical and histologic features of pityriasis lichenoides et varioliformis acuta in children.

Pityriasis lichenoides et varioliformis acuta (PLEVA) is commonly thought of as a disease of young adults, yet we identified five cases, involving patients who were 3, 5, 6, 8, and 11 years of age, among 13,000 consecutive specimens submitted to a general dermatopathology laboratory during a 15-week period. The clinical and histologic features of PLEVA in our cases were similar to those reported for adults, except that no lesions were observed on the scalp or mucous membranes of children. A high index of suspicion and biopsy specimens of suspected lesions are often needed to differentiate PLEVA from other papular and crusted eruptions seen in the pediatric age group. These include reactions to arthropods, Gianotti-Crosti syndrome, varicella, and erythema multiforme. Histologically, papular eczema and pityriasis rosea may be misdiagnosed as PLEVA.

Acute Disease↗
PubMed1987

[Clinical aspects and therapy of frequent diseases of the oral mucosa].

Different diseases of the oral mucosa may closely resemble each other and may therefore pose considerable differential diagnostic problems. The most frequent oral mucous membrane disorders are briefly presented according to their main clinical feature. Recurrent aphthous ulcerations have to be differentiated from viral infections causing aphthoid defects. Blisters and erosions are characteristic for erythema multiforme and oral lesions of bullous autoimmune dermatoses. Leucoplakias may be due to exogenous irritant factors, but may also be a symptom of oral disease. Warts and granulomas may simulate malignant tumours. Pigmentations are due to a variety of endogenous and exogenous factors. Some very frequent, but harmless alterations of the tongue are also briefly described.

Diagnosis, Differential↗
PubMed1986

Toxic epidermal necrolysis.

Toxic epidermal necrolysis (TEN) is a symptom complex characterized by a devastating skin disorder, erosive involvement of two or more mucous membranes, and severe constitutional symptoms. The disorder shares features with erythema multiforme and is thought to be an expression of the syndrome. Although a wide range of etiologic factors have been incriminated in TEN, only a few cases have provided convincing evidence of a direct causal link. Most cases of TEN have been associated with drug administration.

Adolescent↗
PubMed1986

[Iodine and delayed immunity].

Iodine was and is sometimes used therapeutically in various pathologies where the immune mechanism is known to play a dominant role. It has in fact been administered to patients with tubercular granulomatous, lepromatous, syphilitic and mycotic lesions where it facilitates cure. This effect does not depend on iodine's action on the micro-organism responsible. Iodine may also be used in Villanova-Panol Panniculitis, in erythema nodosum, in nodular vasculitis, erythema multiforme and Sweet's syndrome. Oral iodine is also very effective in the lymphatic-cutaneous form of sporotrichosis. In order to establish a relationship between dietary iodine and immune response, 607 infants residing in an area of endemic goitre were studied: 215 were given Lugol solution (2 drops a week for about 8 months) and 392 not. The immune response was assessed by the skin test method using tetanic toxoid and a clear correlation was shown between this and lymphocyte stimulation and monocytic chemotaxis tests. The test was considered positive when an infiltration of at least 5 mm in diameter was shown after 48 hours (in the U.S. 80% of paediatric cases aged 2-10 years old were positive). A significant difference was noted in the average diameter of the infiltrations after the tetanic toxoid skin test in the two groups considered (P less than 0.001). The results appear to indicate that an adequate iodine intake is necessary for normal retarded immune response. The molecular mechanism by which iodine increases immune response is still to be decided.

Chemotaxis, Leukocyte↗
PubMed1985

The spectrum of relapsing fever in the Rocky Mountains.

Between 1940 and 1976, two cases of tick-borne relapsing fever were reported in Colorado, but since 1977, 23 confirmed cases have occurred. All patients had fever, with a mean of 2.8 febrile episodes (range, one to six). Complications included thrombocytopenia, endophthalmitis, meningitis, abortion, in utero infection, and erythema multiforme. All treated patients were eventually cured with antibiotics, although two pregnant patients failed to be cured by their initial courses of antibiotics. Seven of 21 treated patients had Jarisch-Herxheimer reactions, three of whom required intensive care. Five of nine patients who received tetracycline at an initial dose of 5 mg/kg or more had reactions v none of four patients treated with lower doses. Possible causes of the recent increased incidence include increased physician awareness and reporting, improved diagnostic techniques, and an actual increase due to a larger population at risk. Because summertime visits to the Rocky Mountains are becoming increasingly popular, physicians elsewhere should know how to recognize and treat this condition.

Adolescent↗
PubMed1985

Septicemia with two distinct strains of Staphylococcus aureus and dwarf variants of both.

A patient with erythema multiforme developed septicemia with two strains of Staphylococcus aureus. Six blood cultures, obtained during 14 days, yielded a mixture of both strains. The strains differed in the ability to hemolyze human erythrocytes, in the production of beta-lactamase and in the susceptibility to antibiotics and bacteriophages. Following therapy with gentamicin, a Dwarf colony variant auxotrophic for vitamin K, tryptophan and p-aminobenzoic acid appeared in some of the blood cultures. This variant was apparently derived from one of the offending strains (phage Type 55/71). From other blood cultures, a different type of Dwarf colony variant was obtained; this variant was of the same phage type as the other offending S. aureus strain (Type 85). The metabolic deficiencies of this strain were not unraveled. Both events, the double infection with distinct S. aureus strains, and the emergence of Dwarf variants during antibiotic therapy, are unusual in clinical practice, and will be detected only if laboratory staff pays particular attention to the possible occurrence of such events.

Aged↗
PubMed1985

[Lyell's syndrome and ectodermosis pluriorificialis during treatment with oxicams: 11 cases].

Piroxicam (Feldene) and isoxicam (Vectren) form a part of a new family of non-steroid anti-inflammatory drugs (NSAID) highly used in France: the oxicams. The cutaneous accidents of all kinds are frequent, estimated from 1 to 3 p. 100 of the patients with piroxicam (16, 20). In addition to the maculo-papular eruptions, there has been reported: lichenoid eruption (21), erythroderma (7), purpuric vasculitis (1, 10, 21), pemphigus (12, 14), bullous dermatosis difficult to classify (15), erythema multiforme and Stevens-Johnson's syndrome (3, 6, 7, 9, 13, 21, 23) and at last many photosensitization accidents (3, 8, 11, 19, 20, 21). We report 11 observations of Lyell's syndrome (8 cases) or Stevens-Johnson's syndrome (3 cases) occurred during treatments by isoxicam or piroxicam. Eight women and 3 men aged from 35 to 80 years begin a Lyell's syndrome or a Stevens-Johnson's syndrome after 9 to 45 days (at an average of 16 days) of a treatment by isoxicam (6 cases) or piroxicam (5 cases). Five patients attacked by a Lyell's syndrome are intubated and ventilated and 2 patients die of a septic shock at the ninth and the thirteenth day of evolution: the duration of hospitalization is from 11 days to 3 and a half months for the Lyell's syndromes survivors and from 7 to 19 days in the cases of Stevens-Johnson's syndrome: 7 surviving patients have ocular sequelae with in 2 cases a complete or partial blindness. A slight hepatic cytolysis is observed 5 times and a neutropenia mainly as a lymphopenia 4 times. In 2 observations, the CMV serology is positive.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗