Corticosteroid treatment of erythema multiforme major (Stevens-Johnson syndrome) in children

1997 ◽  
Vol 156 (2) ◽  
pp. 90-93 ◽  
Author(s):  
T. Kakourou ◽  
D. Klontza ◽  
F. Soteropoulou ◽  
C. Kattamis
Keyword(s):  
Erythema Multiforme ◽  
Corticosteroid Treatment ◽  
Stevens Johnson Syndrome ◽  
Johnson Syndrome ◽  
Erythema Multiforme Major

scholarly journals Stevens-Johnson syndrome/ erythema multiforme major and Chlamydia pneumoniae infection in young patients

2010 ◽  
Vol 2 (1) ◽  
pp. 6 ◽  
Author(s):  
Ana Filipa Duarte ◽  
Maria João Cruz ◽  
Elisabete Moreira ◽  
Teresa Baudrier ◽  
Alberto Mota ◽  
...  
Keyword(s):  
Erythema Multiforme ◽  
Chlamydia Pneumoniae ◽  
Young Patients ◽  
Stevens Johnson Syndrome ◽  
Johnson Syndrome ◽  
Erythema Multiforme Major

Distinguishing between erythema multiforme major and Stevens-Johnson syndrome/toxic epidermal necrolysis immunopathologically

2012 ◽  
Vol 39 (9) ◽  
pp. 781-786 ◽  
Author(s):  
Shinsaku IWAI ◽  
Hirohiko SUEKI ◽  
Hideaki WATANABE ◽  
Yosuke SASAKI ◽  
Takao SUZUKI ◽  
...  
Keyword(s):  
Toxic Epidermal Necrolysis ◽  
Erythema Multiforme ◽  
Stevens Johnson Syndrome ◽  
Johnson Syndrome ◽  
Erythema Multiforme Major

scholarly journals Stevens-Johnson Syndrome

KYAMC Journal ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. 31-35
Author(s):  
Arpan Kumar Basak ◽  
Joya Debnath
Keyword(s):  
Toxic Epidermal Necrolysis ◽  
Erythema Multiforme ◽  
Primary Care Physicians ◽  
Skin Lesions ◽  
Stevens Johnson Syndrome ◽  
Unknown Etiology ◽  
Initial Report ◽  
Johnson Syndrome ◽  
Erythema Multiforme Major ◽  
Mucous Membranes

Stevens-Johnson syndrome (SJS) is an immune complex mediated hypersensitivity complex that typically involves the skin and mucous membranes. While minor presentations may occur, significant involvement of oral, nasal, eye, vaginal, urethral, gastrointestinal, and lower respiratory mucous membranes may develop in the course of the illness. GI and respiratory involvement may progress to necrosis. Stevens-Johnson syndrome is a serious systemic disorder with the potential for severe morbidity and even death. The syndrome was first described in 1922, when the American pediatricians Albert Mason Stevens and Frank Chambliss Johnson reported the cases of 2 boys aged 7 and 8 years with "an extraordinary, generalized eruption with continued fever, inflamed buccal mucosa, and severe purulent conjunctivitis". Both cases had been misdiagnosed by primary care physicians as hemorrhagic measles. Erythema multiforme (EM), originally described by Von Hebra in 1866, was part of the differential diagnosis in both cases but was excluded because of the 'character of skin lesions, the lack of subjective symptoms, the prolonged high fever, and the terminal heavy crusting". Despite the presence of leucopenia in both cases, Stevens and Johnson in their initial report suspected an infectious disease of unknown etiology as the cause. In 1950, Thomas divided EM into 2 catagories: erythema multiforme minor (Von Hebra) and Erythema multiforme major (EMM). Since 1983, erythema multiforme major and Stevens-Johnson syndrome had been considered synonymous. In the 1990s, however, Bastuji and Roujeau each proposed that Erythema multiforme major and Stevens-Johnson syndrome are 2 distinct disorders. Several investigators propose that Stevens-Johnson syndrome and Toxic epidermal necrolysis (TEN) represent the same disease at different levels of severity. Although several classification schemes have been reported, the simplest breaks the disease down as follows: * Stevens-Johnson syndrome-A "minor form of TEN", with less than 10% body surface area (BSA) detachment. * Overlapping Stevens-Johnson syndrome/Toxic epidermal necrolysis (SJS/TEN)-Detachment of 10-30% BSA. * Toxic epidermal necrolysis-Detachment of more than 30%BSA.KYAMC Journal Vol. 8, No.-2, Jan 2018, Page 31-35

Rash and Mucositis Associated With Mycoplasma pneumoniae and Chlamydophila pneumoniae: A Recurrence of MIRM?

2020 ◽  
Author(s):  
Danielle Brazel ◽  
Brooke Kulp ◽  
Geoanna Bautista ◽  
Andrew Bonwit
Keyword(s):  
Mycoplasma Pneumoniae ◽  
Treatment Options ◽  
Specific Treatment ◽  
Corticosteroid Treatment ◽  
Stevens Johnson Syndrome ◽  
First Case ◽  
Johnson Syndrome ◽  
Vesicular Rash ◽  
Recurrent Aphthous Ulcers ◽  
Definition Of

Abstract Introduction A new concept has come to light recently, that is, Mycoplasma-induced rash and mucositis (MIRM). Here, we report the first case of recurrent rash, mucositis, and conjunctivitis involving Mycoplasma pneumoniae and C. pneumoniae that fits under the criteria of what is currently defined as MIRM. Case Presentation A patient aged 12 years with a history of recurrent aphthous ulcers presented in 2013 with worsening oral lesions, conjunctivitis, and vesicular rash. Her respiratory polymerase chain reaction (PCR) panel was positive for M. pneumoniae. She was diagnosed with Stevens-Johnson syndrome (SJS) secondary to M. pneumoniae and treated with a macrolide, acyclovir, and intravenous immunoglobulin (IVIG). The same patient returned 3 years later with an identical constellation of symptoms, at which time her PCR was positive for C. pneumoniae. In addition to IVIG and a macrolide, a corticosteroid treatment was administered. Discussion Here, we present the case of a pediatric patient with a recurrence of mucocutaneous disease that is more consistent with MIRM than the proposed SJS or erythema multiforme (EM) documented via histology. Our patient’s symptoms were controlled with azithromycin and IVIG and, in the second episode, with corticosteroids as well. This case adds to that of Mayor-Ibarguren et al, providing further evidence that C. pneumonia may also be a trigger for MIRM. Patients will benefit from expanding the definition of MIRM, as the pathogenesis differs from SJS and EM and could result in more specific treatment options.

Warning against long-acting sulphonamides

1966 ◽  
Vol 4 (4) ◽  
pp. 13-13
Keyword(s):  
United States ◽  
Mortality Rate ◽  
Erythema Multiforme ◽  
The United States ◽  
Stevens Johnson Syndrome ◽  
Warning Letter ◽  
Johnson Syndrome ◽  
The Us ◽  
Mucous Membranes ◽  
Long Acting

Last month the US Food and Drug Administration required American manufacturers of long-acting sulphonamides (sulphamethoxypyridazine, Lederkyn - Lederle and Midicel - PD; sulphadimethoxine - Madribon - Roche) to warn prescribers that in rare cases the Stevens-Johnson syndrome may develop as a severe and sometimes fatal side effect. This syndrome is a type of erythema multiforme in which large blisters appear on the skin and especially on the mucous membranes. The manufacturers were also to advise doctors ‘to consider prescribing short-acting sulphonamides first because they are effective for most of the same conditions’. The three drug firms concerned accordingly sent a joint warning letter to all doctors, pointing out that the Stevens-Johnson syndrome is a serious complication with a mortality rate of about 25%. So far 116 cases of this syndrome have been reported in association with the use of long-acting sulphonamides, most of them in the United States. Almost two thirds of the patients were children.

Head and Neck Manifestations of Erythema Multiforme in Children

1994 ◽  
Vol 111 (3P1) ◽  
pp. 236-242 ◽  
Author(s):  
Michael G. Stewart ◽  
Newton O. Duncan ◽  
Daniel J. Franklin ◽  
Ellen M. Friedman ◽  
Marcelle Sulek
Keyword(s):  
Oral Cavity ◽  
Toxic Epidermal Necrolysis ◽  
Head And Neck ◽  
Erythema Multiforme ◽  
Medication Use ◽  
Stevens Johnson Syndrome ◽  
Striking Increase ◽  
Johnson Syndrome ◽  
Mucosal Involvement ◽  
Mucous Membranes

Erythema multiforme, Stevens-Johnson syndrome, and toxic epidermal necrolysis are related disorders of skin and mucous membranes, which are typically associated with antecedent medication use or infection. We review 108 cases of erythema multiforme, Stevens-Johnson syndrome, and toxic epidermal necrolysis from Texas Children's Hospital, Houston, Texas, from 1981 to 1991, and illustrate the characteristic skin and mucosal lesions. In addition, we describe in detail two unusual cases requiring intensive airway management. Head and neck manifestations were present in 4 of 79 patients (5%) with erythema multiforme and 26 of 28 patients (93%) with Stevens-Johnson syndrome. In Stevens-Johnson syndrome, mucosal involvement of the lip (93%), conjunctiva (82%), oral cavity (79%), and nose (36%) were most common. Antecedent medication use was identified in 59% of erythema multiforme patients and 68% of Stevens-Johnson syndrome patients. We note a striking increase in the number of cases in our series caused by cephalosporins. Fifty percent of Stevens-Johnson syndrome patients required supplemental hydration or alimentation because of the severity of the oral cavity involvement. The head and neck mucosal manifestations largely respond to local care, and the routine use of prophylactic antibiotics or systemic steroids is not recommended.

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