Silva Kelly Regina Pereira da, Sardini Covello Giaccio Rafaela, Martins de Aquino Bárbara, Abellan Van Moorsel Marina, Mazziero Pires Fernanda, Hélène Carolina Maria, Hélène Selma Maria Furman
Faculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Hospital Municipal Dr. Moysés Deutsch, São Paulo, SP, Brazil.
Einstein (Sao Paulo). 2025 Jun 13;23:eRC1138. doi: 10.31744/einstein_journal/2025RC1138. eCollection 2025.
Mycoplasma-induced rash and mucositis is a distinctive subset of reactive infectious mucocutaneous eruption identified in 2015 to differentiate it from other mucocutaneous disorders such as Stevens-Johnson syndrome, erythema multiforme major, and toxic epidermal necrolysis. Although its pathophysiology is not completely understood, Mycoplasma-induced rash and mucositis is characterized by polyclonal B cell proliferation, production of antibodies against Mycoplasma pneumoniae, subsequent immune complex deposition, and keratinocyte apoptosis. Clinical manifestations include scattered cutaneous lesions and severe mucositis, which predominantly affect children and young males. In this report, we present the case of a 4-year-old boy with characteristic Mycoplasma-induced rash and mucositis symptoms, including erythematous annular lesions, mucosal involvement, and positive serologies for Mycoplasma pneumoniae and herpes simplex. The diagnostic challenges, treatment modalities, and differential diagnosis of erythema multiforme major are discussed. Our case underscores the importance of recognizing Mycoplasma-induced rash and mucositis as a distinct entity, facilitating accurate diagnosis and tailoring management strategies to optimize patient outcomes.
支原体感染性皮疹和黏膜炎是2015年确定的一种独特的反应性感染性黏膜皮肤疹亚型,以区别于其他黏膜皮肤疾病,如史蒂文斯-约翰逊综合征、重症多形红斑和中毒性表皮坏死松解症。尽管其病理生理学尚未完全明确,但支原体感染性皮疹和黏膜炎的特征为多克隆B细胞增殖、产生抗肺炎支原体抗体、随后免疫复合物沉积以及角质形成细胞凋亡。临床表现包括散在的皮肤损害和严重的黏膜炎。该疾病主要影响儿童和年轻男性。在本报告中,我们介绍了一名4岁男孩的病例,其具有典型的支原体感染性皮疹和黏膜炎症状,包括环状红斑性损害、黏膜受累以及肺炎支原体和单纯疱疹血清学检查呈阳性。文中讨论了重症多形红斑的诊断挑战、治疗方式及鉴别诊断。我们的病例强调了将支原体感染性皮疹和黏膜炎识别为一种独特疾病的重要性,有助于准确诊断并制定个性化管理策略以优化患者预后。