Siedner-Weintraub Yael, Gross Itai, David Almog, Reif Shimon, Molho-Pessach Vered
Pediatric Division, Hadassah-Hebrew University Medical Center, 91120 Jerusalem, Israel.
Acta Derm Venereol. 2017 Apr 6;97(4):489-492. doi: 10.2340/00015555-2569.
Erythema multiforme (EM) is an immune-mediated reaction presenting as acrofacial target lesions. Most studies utilize the outdated classification, which includes EM, Stevens-Johnson syndrome and toxic epidermal necrolysis as related entities. We describe here epidemiological, aetiological, clinical, laboratory and treatment characteristics of paediatric EM. This is a retrospective single-centre study, performed between 2000 and 2013. Of 119 children given a diagnosis of EM, only 30 met clinical criteria and were included in this study. Most misdiagnosed cases were non-specific eruptions and urticaria multiforme. Mean age was 11.3 years. Fifty percent had mucosal involvement. An aetiology was observed in half of the patients. Seventy percent of patients were admitted to hospital, 46.7% were treated with systemic steroids. Sixteen percent had recurrent EM. The most common identified infectious agent associated with EM in this study was Mycoplasma pneumonia and the cases associated with this infection may represent the recent entity, mycoplasma-induced rash and mucositis. Association with herpes simplex virus was not observed. Despite being a benign, self-limiting condition, children were over-treated in terms of hospitalization and therapy.
多形红斑(EM)是一种免疫介导的反应,表现为肢端面部靶形皮损。大多数研究采用的是过时的分类方法,该方法将多形红斑、史蒂文斯-约翰逊综合征和中毒性表皮坏死松解症视为相关疾病。我们在此描述儿童多形红斑的流行病学、病因学、临床、实验室及治疗特征。这是一项2000年至2013年间进行的回顾性单中心研究。在119例被诊断为多形红斑的儿童中,只有30例符合临床标准并纳入本研究。大多数误诊病例为非特异性皮疹和多形性荨麻疹。平均年龄为11.3岁。50%的患者有黏膜受累。一半的患者观察到了病因。70%的患者入院治疗,46.7%的患者接受了全身类固醇治疗。16%的患者有多形红斑复发。本研究中与多形红斑相关的最常见病原体是肺炎支原体,与该感染相关的病例可能代表了最近发现的疾病——支原体诱发的皮疹和黏膜炎症。未观察到与单纯疱疹病毒的关联。尽管多形红斑是一种良性的自限性疾病,但儿童在住院和治疗方面仍存在过度治疗的情况。