scholarly journals Drug-induced oral erythema multiforme: A diagnostic challenge

2018 ◽  
Vol 17 (1) ◽  
pp. 43 ◽  
Author(s):  
SyedAhmed Taqi
Keyword(s):  
Erythema Multiforme ◽  
Diagnostic Challenge ◽  
Drug Induced

Immunohistochemical Expression of Apoptotic Markers in Drug-Induced Erythema Multiforme, Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis

2007 ◽  
Vol 20 (3) ◽  
pp. 557-566 ◽  
Author(s):  
A.V. Marzano ◽  
A. Frezzolini ◽  
M. Caproni ◽  
A. Parodi ◽  
D. Fanoni ◽  
...  
Keyword(s):  
Toxic Epidermal Necrolysis ◽  
Erythema Multiforme ◽  
Fas Ligand ◽  
Normal Skin ◽  
Basal Layer ◽  
Immunohistochemical Analysis ◽  
Stevens Johnson Syndrome ◽  
Drug Induced ◽  
Johnson Syndrome ◽  
Dermal Infiltrate

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are considered to be severity variants of the same disease, which is almost always associated with drug intake. In contrast, erythema multiforme (EM) is a disorder regarded as only rarely caused by drugs. Keratinocyte apoptosis has been shown to play an important part in the pathogenesis of SJS and TEN, whilst its role in EM remains controversial. To determine the expression of apoptosis-associated molecules Fas, Fas ligand (FasL), Bcl-2 and Bax in the above disorders, an immunohistochemical analysis was performed. We studied both lesional skin from thirty patients having drug-induced EM and 5 cases classified within the SJS/TEN spectrum and normal skin samples. We found a keratinocyte overexpression of Fas antigen, an important molecule mediating apoptosis, not only in SJS and TEN but also in EM. Another noteworthy finding was the strong expression of Bcl-2, a protein known as blocking apoptosis, along the basal layer and in the dermal infiltrate both in SJS/TEN and in EM. Taken together, these findings suggest that Fas-dependent keratinocyte apoptosis may play a part in the pathogenesis of both SJS/TEN and EM. Fas-mediated cell death may be partially suppressed by the Bcl-2 protein.

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

2021 ◽  
Vol 9 ◽  
Author(s):  
Xiaomei Fan ◽  
Yong Luo ◽  
Jieluan Lu ◽  
Jinji Xu ◽  
Qing Chen ◽  
...  
Keyword(s):  
Case Report ◽  
Erythema Multiforme ◽  
Clinical Symptoms ◽  
Specific Treatment ◽  
Human Leukocyte ◽  
Community Acquired Pneumonia ◽  
The Body ◽  
Drug Induced ◽  
Chemical Structures ◽  
Erythema Multiforme Major

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.

scholarly journals Drug induced oral erythema multiforme

Medicine ◽  
2021 ◽  
Vol 100 (17) ◽  
pp. e22387
Author(s):  
Shaik Mohamed Asif ◽  
Shaik Mohamed Shamsudeen ◽  
Khalil Ibrahim Assiri ◽  
Hussain Mohammed Al Muburak ◽  
Sultan Mohammed Kaleem ◽  
...  
Keyword(s):  
Erythema Multiforme ◽  
Drug Induced

Imipramine-Induced Facial Pigmentation: Case Report and Literature Review

2005 ◽  
Vol 9 (6) ◽  
pp. 341-345 ◽  
Author(s):  
Andrei I. Metelitsa ◽  
Gia-Khanh Nguyen ◽  
Andrew N. Lin
Keyword(s):  
Light Microscopy ◽  
Skin Pigmentation ◽  
Pigment Granule ◽  
Slight Improvement ◽  
Diagnostic Challenge ◽  
Drug Induced ◽  
Dense Bodies ◽  
Patient Reported ◽  
Blue Stain ◽  
Microscopic Findings

Background: Patients who present with facial pigmentation can be a diagnostic challenge. ObjectiveThe goal of this study was to discuss the diagnosis and management of imipramine-induced facial pigmentation. Methods: We describe a patient with facial pigmentation of 26 years' duration that was associated with imipramine treatment for depression. We discuss light and election microscopic findings and review 11 previously reported cases of imipramine-induced skin pigmentation. Results: Examination showed blue-gray facial pigmentation. Light microscopy showed perivascular pigment granule deposits in the upper dermis that stained positively with Fontana–Masson stain and negatively with Prussian blue stain. Electron microscopy showed electron-dense bodies within histiocytes without clearly identifiable melanin granules, consistent with drug-induced pigmentation. Six weeks after switching to sertraline the patient reported a slight improvement of her cutaneous pigmentation. Conclusion: Imipramine is a rare cause of gray-blue facial pigmentation. Light microscopy consistently shows granular dermal deposits that stain positively with Fontana-Masson stain but negatively with iron stain.

Drug-Induced Oral Erythema Multiforme

Dermatology ◽  
1984 ◽  
Vol 168 (1) ◽  
pp. 35-40 ◽  
Author(s):  
K. Gebel ◽  
O.P. Hornstein
Keyword(s):  
Erythema Multiforme ◽  
Drug Induced

scholarly journals Drug induced aseptic meningitis: A diagnostic challenge

2014 ◽  
Vol 41 (2) ◽  
pp. 138 ◽  
Author(s):  
AI Frank-Briggs ◽  
OJ Oluwatade
Keyword(s):  
Aseptic Meningitis ◽  
Diagnostic Challenge ◽  
Drug Induced
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