Reactive Infectious Mucocutaneous Eruption (RIME): Narrative Review and Proposed Management Algorithm.

INTRODUCTION

RIME is an emerging dermatologic condition marked by prominent mucositis with minimal skin involvement, often mimicking Stevens-Johnson syndrome. While initially linked to Mycoplasma pneumoniae, a broader range of infectious triggers is now recognized.

OBJECTIVES

We present a narrative review of this entity. A proposed diagnostic and therapeutic algorithm is also provided to aid clinicians in clinical practice.

METHODS

We performed a narrative review of English-language literature on RIME and MIRM indexed in PubMed through 2024, supplemented by clinical insights from the experience of our centre.

RESULTS

Evidence regarding treatment is lacking, with systemic steroids and/or cyclosporine A showing the most benefit. RIME usually portends a good prognosis, with recovery within seven to 21 days, although complications can occur. Recurrences are rare, and subsequent episodes can be triggered by different microorganisms.

CONCLUSIONS

RIME represents a distinct clinical entity with a broadening range of infectious triggers beyond Mycoplasma pneumoniae. Prompt recognition, accurate differentiation from mimickers, and a structured diagnostic and therapeutic approach are essential for effective management and improved patient outcomes.