Erythema Multiforme Major in Angioimmunoblastic T-cell Lymphoma

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Erythema multiforme major with ocular involvement following COVID-19 infection

ABSTRACT We report a case of membranous conjunctivitis and erythema multiforme major (EMM) after a coronavirus disease 2019 (COVID-19) diagnosis. A previously well 18-year-old man presented with increasingly erythematous eyes and oral and genital ulceration 2 weeks after confirmation of COVID-19 infection. Clinical examination showed sloughy membranous conjunctivitis with normal visual acuity. He was reviewed by dermatology and diagnosed with EMM secondary to severe acute respiratory syndrome coronavirus 2 infection. The symptoms resolved with oral and topical steroids, lubricants and chloramphenicol eye drops. Erythema multiforme has been reported in association with COVID-19, although the major form is rare. Ophthalmologists should consider current or previous COVID-19 infection in patients presenting with conjunctivitis or pseudomembrane formation. Prompt initiation of steroids aids resolution.

STEROID INDUCED PSYCHOSIS IN A CASE OF ERYTHEMA MULTIFORME MAJOR.

Corticosteroids have been documented to cause psychiatric disturbances to various degree. We report a case of psychosis in a case of erythema multiforme major treated with steroids that presented to psychiatric outpatient department requiring medical management. A 32 years old female was brought to psychiatry outpatient department following behavioural disturbances. Patient had a history of recently suffering from Erythema Multiforme major following a dose of injectable ceftriaxone. After being treated with injectable and oral dose of corticosteroids she developed behavioural disturbances. On detailed evaluation patient was diagnosed to be suffering from Substance/medication-induced psychotic disorder as per DSM-5. She was started on treatment with Tab. Olanzapine (5mg) HS and Tab. Clonazepam (0.5 mg) HS with which her symptoms improved and remitted completely within few weeks. Corticosteroid induced psychosis can be managed with tapering of steroid dosages and / or addition of psychotropic medication. This case emphasizes on the need of liaison-based approach for a holistic management in such cases.Further research is essential to establish the course of illness and long-term prognosis in these patients

Erythema Multiforme Major Associated With Community-Acquired Pneumonia: Lessons From a Case Report

Background: Erythema multiforme (EM) is an acute immune-mediated inflammatory mucinous skin disorder. The etiology of pediatric EM involves infections, medications, autoimmune diseases, and genetic factors.Case Report: An 8-year-old girl with Mycoplasma pneumoniae (MP) associated community-acquired pneumonia developed erythema target-like symptoms 1 week after azithromycin administration. The erythema quickly spread throughout the body involving the oral and ocular mucous membranes, the trunk, and the extremities, and eventually developed into erythema multiform major (EMM). Through drug withdrawal and specific treatment including systemic corticosteroids and supportive care, her clinical symptoms were improved. After 31 days, most of the mucocutaneous symptoms were relieved, except pigmentation. Human leukocyte antigen (HLA) gene sequencing was performed and 20 HLA genotypes were identified. The patient follow-up lasted for 18 months. Rashes appeared on her trunk when receiving azithromycin orally after discharge and then disappeared after azithromycin withdrawal.Conclusions: Pediatric EM is a rare disease and recognition of its etiology is important for EM management. In this case, azithromycin and HLA-DQB1*03:01 genotype may contribute to EMM.Lesson: For drug-induced EM, rapid identification and withdrawal of the causative drugs is critical. Re-exposure to the same drug or exposure to drugs with similar chemical structures should also be avoided. Patient education and rational use of medicines are essential for pediatric patients.

Paracetamol induced erythema multiforme major: a rare case report

Paracetamol is the most quotidian drug used for fever and pain. Adverse drug reaction to paracetamol in India are rare, at times they can lead to lethal situations like erythema multiforme. The most common drug induced erythema multiforme are due to drugs like barbiturate, NSAIDs, penicillin, sulfonamide, nitrofurantoin, phenothiazines and anticonvulsants. There are very few detailed case reports of erythema multiforme due to use of paracetamol. We report a case of erythema multiforme which occurred due to use of paracetamol. The clinical feature and management of patient are described in brief.