Liakos William, Xu Amy, Finelt Nika
Department of Dermatology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY, USA.
Pediatr Dermatol. 2021 Jan;38(1):154-158. doi: 10.1111/pde.14472. Epub 2020 Nov 28.
BACKGROUND/OBJECTIVES: The characteristics of patients experiencing recurrent Mycoplasma pneumoniae-induced rash and mucositis (MIRM) are not well understood. We aimed to characterize patients with recurrent disease by comparing the demographics, skin and mucosal involvement, seasonality, and treatment to those with single episodes (isolated MIRM).
This retrospective case series screened all patients seen by our dermatology inpatient consult service from September 2014 to March 2020. Cases were selected based on laboratory and clinical criteria that confirmed a diagnosis of MIRM.
We identified 13 patients with MIRM: 5 who experienced recurrence (38%) and 8 with isolated, single episodes without recurrence. Mean age was 13.6 years for initial episodes in the recurrent patients compared to 11.7 in patients with isolated episodes. All 5 recurrent MIRM patients were male (compared with 75% of isolated MIRM patients) and predominantly Black (60%, compared with 25%). Most episodes overall (isolated and recurrent) occurred from the months of October to February. Recurrences after initial MIRM episode had less severe skin and mucosal findings, often involving only one mucous membrane, less frequent need for hospital admission, and shorter duration of hospital stay. Prophylactic treatments and treatments beyond supportive care were of unclear value.
Some characteristics of MIRM differ between patients with recurrent and isolated disease. Clinicians should be aware of the potential for recurrence, which occurred in 38% of our cohort. Although recurrences after initial MIRM episode tended to be less severe, there is still potential for prolonged hospitalizations with recurrent episodes. More evidence is needed regarding effective preventive and treatment regimens in patients with recurrent MIRM.
背景/目的：复发性肺炎支原体感染伴发皮疹和黏膜炎症（MIRM）患者的特征尚未完全明确。我们旨在通过比较复发性疾病患者与单次发作患者（孤立性MIRM）的人口统计学特征、皮肤和黏膜受累情况、季节性以及治疗方法，来描述复发性疾病患者的特征。
本回顾性病例系列研究筛选了2014年9月至2020年3月期间由我们皮肤科住院会诊服务诊治的所有患者。根据实验室和临床标准选择病例，确诊为MIRM。
我们确定了13例MIRM患者：5例经历复发（38%），8例为孤立的单次发作且无复发。复发性患者初次发作的平均年龄为13.6岁，而孤立性发作患者为11.7岁。所有5例复发性MIRM患者均为男性（相比之下，孤立性MIRM患者中75%为男性），且主要为黑人（60%，相比之下，孤立性MIRM患者中为25%）。总体而言，大多数发作（孤立性和复发性）发生在10月至2月。初次MIRM发作后的复发，其皮肤和黏膜表现较轻，通常仅累及一个黏膜，住院需求较少，住院时间较短。预防性治疗和支持治疗以外的治疗价值尚不明确。
复发性和孤立性疾病患者的MIRM某些特征有所不同。临床医生应意识到复发的可能性，在我们的队列中复发率为38%。虽然初次MIRM发作后的复发往往不太严重，但复发仍有可能导致住院时间延长。对于复发性MIRM患者有效的预防和治疗方案，还需要更多证据。
