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    Depigmenting Erythema Multiforme.
    Indian J Dermatol Venereol Leprol 1980 Mar-Apr;46(2):117-120
    Two patients with a peculiar variant of erythema multiforme are described. The classical iris lesions, appearing seasonally in response to as yet unidentifiable agents, resolved leaving behind persistent depigmentation. Although, the EM lesions aborted on cordcosteroid therapy, the latter seemed to have no effect on the depigmented spots. Read More

    Paraneoplastic pemphigus associated with Castleman disease: Progression from mucous to mucocutaneous lesions with epitope-spreading phenomena.
    Br J Dermatol 2017 Feb 18. Epub 2017 Feb 18.
    Departments of Dermatology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan.
    Paraneoplastic pemphigus (PNP) is a frequently fatal autoimmune blistering disease of the skin and mucous membranes.(1) PNP is commonly associated with malignant neoplasms or haematological disorders like Castleman disease (CD). The eruptions may resemble those seen in various other conditions such as lichen planus (LP), graft-versus-host disease, erythema multiforme (EM), bullous pemphigoid and pemphigus vulgaris (PV). Read More


    An exploratory factor analysis of the spontaneous reporting of severe cutaneous adverse reactions.
    Ther Adv Drug Saf 2017 Jan 29;8(1):4-16. Epub 2016 Nov 29.
    Pfizer Inc., New York, NY, USA.
    Background: Severe cutaneous adverse reactions (SCARs) are prominent in pharmacovigilance (PhV). They have some commonalities such as nonimmediate nature and T-cell mediation and rare overlap syndromes have been documented, most commonly involving acute generalized exanthematous pustulosis (AGEP) and drug rash with eosinophilia and systemic symptoms (DRESS), and DRESS and toxic epidermal necrolysis (TEN). However, they display diverse clinical phenotypes and variations in specific T-cell immune response profiles, plus some specific genotype-phenotype associations. Read More

    Vesicular Contact Reaction May Progress into Erythema Multiforme.
    Acta Dermatovenerol Croat 2016 Dec;24(4):307-309
    Prof. Magdalena Czarnecka-Operacz, MD, PhD, Department of Dermatology, 49 Przybyszewski Str., 60-355 Poznań, Poland.
    Dear Editor, Erythema multiforme is considered an acute skin condition, characterized by a self-limiting and sometimes recurrent course. It is regarded as a type IV hypersensitivity reaction associated with certain infections, medications, and other various triggers. Allergic contact dermatitis is in turn a delayed type of induced allergy as a result of cutaneous contact with a specific allergen to which the patient develops specific sensitivity. Read More

    Anticonvulsant hypersensitivity syndrome secondary to carbamazepine.
    Proc (Bayl Univ Med Cent) 2017 Jan;30(1):94-96
    Department of Internal Medicine, Baylor Scott & White Hospital, Temple, Texas.
    Anticonvulsant hypersensitivity syndrome (AHS) is a potentially fatal multiorgan drug reaction that presents with various cutaneous eruptions. There is a genetic predisposition to such reactions. We present a young woman with AHS due to carbamazepine that presented as an atypical erythema multiforme with elevated liver enzymes. Read More

    Alectinib-Induced Erythema Multiforme and Successful Rechallenge with Alectinib in a Patient with Anaplastic Lymphoma Kinase-Rearranged Lung Cancer.
    Case Rep Oncol 2016 Sep-Dec;9(3):826-832. Epub 2016 Dec 8.
    Department of Premier Preventive Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan; Department of Respiratory Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan.
    Background: Alectinib is an oral drug developed for the treatment of patients with fusion gene encoding echinoderm microtubule-associated protein-like 4-anaplastic lymphoma kinase (EML4-ALK)-rearranged non-small cell lung cancer (NSCLC). Here, we present the case of a patient treated with alectinib who developed a hypersensitivity reaction with successful rechallenge treatment.

    Case Presentation: A 39-year-old woman who was a passive smoker was referred to Osaka City University Hospital for the evaluation of a skin event caused by treatment for NSCLC with the fusion gene EML4-ALK. Read More

    ISMP Adverse Drug Reactions: Sildenafil-Induced Erythema Multiforme Acute Liver Injury Due to Febuxostat Intravenous Acetaminophen-Induced Acute Hepatotoxicity Acute Transient Myopia Induced by Zanamivir Lidocaine-Induced Hoigne Syndrome.
    Hosp Pharm 2016 Dec;51(11):884-887
    The purpose of this feature is to heighten awareness of specific adverse drug reactions (ADRs), discuss methods of prevention, and promote reporting of ADRs to the US Food and Drug Administration's (FDA's) MedWatch program (800-FDA-1088). If you have reported an interesting, preventable ADR to MedWatch, please consider sharing the account with our readers. Write to Dr. Read More

    Inflammatory Skin Conditions Associated With Radiotherapy.
    Actas Dermosifiliogr 2016 Dec 20. Epub 2016 Dec 20.
    Servicio de Dermatología, Hospital General Universitario Gregorio Marañón, Madrid, España.
    Radiotherapy for cancer is used increasingly. Because skin cells undergo rapid turnover, the ionizing radiation of radiotherapy has collateral effects that are often expressed in inflammatory reactions. Some of these reactions-radiodermatitis and recall phenomenon, for example-are very familiar to dermatologists. Read More

    Erythema exsudativum multiforme induced by a taurine-containing energy drink.
    Acta Dermatovenerol Alp Pannonica Adriat 2016 Dec;25(4):83-84
    Department of Nuclear Medicine, University Clinical Center of Kosovo, Prishtina, Kosovo.
    Erythema exsudativum multiforme is an immunologically mediated skin condition caused by viruses, bacteria, food, and drugs. There are different forms, and depending on the severity of the disease there is a major and minor form. Whereas the minor form passes without consequences, the major form and Stevens-Johnson syndrome affect the mucosa and may result in death. Read More

    Is this a simple drug eruption to be discharged?
    Turk J Emerg Med 2016 Dec 14;16(4):176-178. Epub 2016 Jun 14.
    Ataturk University Education and Research Hospital, Department of Emergency Medicine, Erzurum, Turkey.
    'Erythema Multiforme associated with Phenytoin And Cranial radiation Therapy' (EMPACT) is a very rare clinic situation and classified in EM-like drug reactions. It can be easily misdiagnosed as acute urticaria or drug eruption in ED. Initial symptoms may resemble a simple skin problem, but diagnosing and early hospitalization of the patients can be lifesaving. Read More

    Paediatric Erythema Multiforme: Epidemiological, Clinical and Laboratory Characteristics.
    Acta Derm Venereol 2016 Nov 10. Epub 2016 Nov 10.
    Pediatric Division, Hadassah-Hebrew University Medical Center, 91120 Jerusalem, Israel.
    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. Read More

    Erythema multiforme-like cutaneous lesions in monomorphic epitheliotropic intestinal T-cell lymphoma: a rare case report.
    J Cutan Pathol 2017 Feb 15;44(2):183-188. Epub 2016 Dec 15.
    Hematology Unit, Bangkok-Hatyai Hospital, Songkhla, Thailand.
    Monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL), also known as Type II enteropathy-associated T-cell lymphoma (EATL), is an aggressive peripheral T-cell lymphoma. EATL generally presents in adults with gastrointestinal symptoms. Skin involvement is very rare, found only in approximately five percent of patients. Read More

    Treatment of antiviral-resistant recurrent erythema multiforme with dapsone.
    Dermatol Ther 2016 Nov 18. Epub 2016 Nov 18.
    Department of Dermatology, University of Alabama at Birmingham, Birmingham, AL.
    Recurrent erythema multiforme (REM) is a chronic disease characterized by frequent episodes of target cutaneous lesions in an acral distribution. Conventional treatment includes systemic corticosteroids and antiviral therapy. The aim of this study was to evaluate dapsone as a potential steroid sparing-agent for the treatment of REM after a failed trial of at least one antiviral therapy (acyclovir, famciclovir, or valacyclovir). Read More

    Treatment of a Pregnant Patient with Herpes Associated Erythema Multiforme (HAEM): A case report.
    Acta Stomatol Croat 2016 Sep;50(3):265-268
    Oral Medicine Department, Faculty of Dentistry Chulalongkorn University, Bangkok, Thailand.
    Erythema Multiforme, (EM) is an uncommon, acute inflammatory disease of the skin and mucous membranes characterized by ulcerations caused by hypersensitivity to drugs, microbial agents or other allergens. An EM outbreak can result in more severe forms of EM involving the skin, and there are several types of EM manifestations. A hemorrhagic crust on the lip is a pathognomonic sign of this disease. Read More

    Autoimmune estrogen dermatitis in an infertile female.
    Cutan Ocul Toxicol 2016 Nov 2:1-4. Epub 2016 Nov 2.
    c Department of Obstetrics and Gynaecology , Faculty of Medicine, Hacettepe University , Ankara , Turkey.
    Autoimmune estrogen dermatitis is a cyclical cutaneous eruption that occurs premenstrually and goes to the rapid resolution within a few days of menstrual cycles. The disorder has variable clinical manifestations consisting of macules, papules, vesicles, urticarial lesions, bullae, eczematous plaques, and erythema multiforme-like lesions. Herein, we present a case of a 30-year-old woman with attacks of edema and erosions involving the oral and genital mucosal sites on every first day of her menstruation period. Read More

    Drug-induced cutaneous lupus erythematosus: 88 new cases.
    Eur J Dermatol 2017 Feb;27(1):28-33
    Department of Dermatology and Allergy Centre, Odense University Hospital, DK-5000, Odense C, Denmark.
    Background: An increasing number of drugs have been linked to drug-induced subacute cutaneous lupus erythematosus (DI-SCLE). The recognition and management of DI-SCLE can be challenging, as the condition may be triggered by different classes of drugs after variable lengths of time.

    Objectives: To determine the proportion of patients with cutaneous lupus erythematosus (CLE) whose drugs are an inducing or aggravating factor. Read More

    [Childhood postinfectious erythema multiforme].
    Arch Pediatr 2016 Nov 20;23(11):1184-1190. Epub 2016 Sep 20.
    Service de dermatologie, centre hospitalier Victor-Dupouy, 69, rue du Lieutenant-Colonel-Prud'hon, 95100 Argenteuil, France. Electronic address:
    Postinfectious erythema multiforme is an uncommon skin disease in childhood that can have a strong impact, especially in infants if there is involvement of the mucous membranes. The lesion is targeted (central bullous lesions with three concentric circles). Its diagnosis is typically made clinically. Read More

    A case of erythema multiforme drug eruption associated with erythrodermic psoriasis induced by sofosbuvir and daclatasvir.
    J Clin Pharm Ther 2017 Feb 18;42(1):108-110. Epub 2016 Oct 18.
    Department of Infectious Diseases, The First Affiliated Hospital, China Medical University, Shenyang, Liaoning Province, China.
    What Is Known And The Objective: Sofosbuvir (SOF) and daclatasvir (DCV) have revolutionized the treatment of hepatitis C virus and now represent the preferred therapy for this disease. Limited data are available on the dermatological side effects resulting from co-administration of SOF and DCV.

    Case Description: We report a case of an erythema multiforme drug eruption associated with erythrodermic psoriasis induced by SOF and DCV. Read More

    Atypical hand, foot and mouth disease in adults associated with coxsackievirus A6: a clinico-pathologic study.
    J Cutan Pathol 2016 Nov 26;43(11):940-945. Epub 2016 Aug 26.
    Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
    Background: Hand, foot, and mouth disease (HFMD) is a contagious illness most commonly occurring in children 5 years old or younger. The most common cause of HFMD in the United States is Coxsackievirus A16. HFMD is uncommon in adults, and may show other atypical features including a broader spectrum of cutaneous involvement and a greater degree of severity. Read More

    Ocular manifestations of Stevens-Johnson syndrome and their management.
    Curr Opin Ophthalmol 2016 Nov;27(6):522-529
    Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA.
    Purpose Of Review: Recent advances and outcomes data in the management of Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) demonstrate the need for a universal standard of care for patients admitted with the disease.

    Recent Findings: Amniotic membrane transplantation, aggressive topical corticosteroids, and lubrication in the acute stage are necessary to prevent or mitigate long-term ocular sequelae. If chronic ocular disease does occur, several interventions can be employed to prevent progressive vision loss and discomfort. Read More

    The different cutaneous presentations in three cases of Kawasaki disease as confounding factor of diagnosis.
    J Pak Med Assoc 2016 Sep;66(9):1188-1190
    Department of Paediatric Nephrology, Bezmialem Vakif University Medical Faculty, Istanbul, Turkey.
    We report three paediatric cases of Kawasaki disease (KD). Erythema multiforme (EM) was the presenting cutaneous feature in two patients, with young age (43 days old), macular rash and meningitis in the third patient. Diagnosis of KD was difficult due either to initial misdiagnosis of drug eruption, incomplete presentation, or the young age of the patient. Read More

    A practical clinical recording system for cases with desquamative gingivitis.
    Br J Dermatol 2016 Sep 17. Epub 2016 Sep 17.
    WHO Collaborating Centre for Oral Health-General Health; and UCL, UK.
    The most frequent autoimmune disorders that involve the oral mucosae are lichen planus, pemphigoid, pemphigus, epidermolysis bullosa acquisita, erythema multiforme, discoid lupus erythematosus and chronic ulcerative stomatitis, affected individuals presenting with variable oral lesions; mainly(1-3) hyperkeratosis, erythema, blisters, erosions and ulcerations. The gingival tissues are commonly involved, not least because of decreases in oral hygiene(4) but the gingiva can be the unique site of onset or the first manifestation of the disorder(5) often as "desquamative gingivitis" (DG).(3,6,7)(This article is protected by copyright. Read More

    Levofloxacin Induced Toxic Epidermal Necrolysis: Successful Therapy with Omalizumab (Anti-IgE) and Pulse Prednisolone.
    Am J Case Rep 2016 Sep 16;17:666-71. Epub 2016 Sep 16.
    Department of Infectious Diseases, Akdeniz University, Faculty of Medicine, Antalya, Turkey.
    BACKGROUND Toxic epidermal necrolysis (TEN) is characterized by widespread erythematous and bullous lesions on the skin. Nowadays, considerable progress has been made in the understanding of its pathogenesis. Immunologically it is similar to graft-versus-host disease. Read More

    Unusual manifestation of mucosal plasmacytosis mimicking erythema multiforme.
    Dermatol Online J 2016 Jun 15;22(6). Epub 2016 Jun 15.
    Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, India.
    Mucosal plasmacytoses constitute a group of idiopathic inflammatory disorders, characterized by a dense infiltrate of plasma cells at the mucocutaneous junction without any recognizable dermatosis or neoplasm. We report an unusual clinical presentation of mucosal plasmacytosis presenting with hemorrhagic crusting of the lips, mimicking erythema multiforme. Read More

    Apoptosis as a Mechanism for Keratinocyte Death in Canine Toxic Epidermal Necrolysis.
    Vet Pathol 2017 Mar 29;54(2):249-253. Epub 2016 Sep 29.
    2 Comparative Medicine Institute, NC State University, Raleigh, NC, USA.
    In humans and dogs, toxic epidermal necrolysis (TEN) is a life-threatening dermatosis characterized by sudden epidermal death resulting in extensive skin detachment. There is little information on the pathogenesis of keratinocyte cell death in canine TEN. We studied the occurrence of apoptosis in skin lesions of dogs with TEN to determine if apoptosis contributes to the pathogenesis of this disease. Read More

    [Inflammatory diseases of oral mucous membranes].
    Hautarzt 2016 Oct;67(10):786-792
    Klinik und Poliklinik für Dermatologie und Allergologie, Ludwig-Maximilians-Universität, Frauenlobstr. 9-11, 80337, München, Deutschland.
    Background: Mucous membranes are involved in many different inflammatory disorders.

    Methods: We describe the clinical features, diagnostic workup, and therapy of inflammatory diseases of mucous membranes.

    Results: The diagnostic workup is based on medical history, clinical manifestations, histopathology, and serology. Read More

    HLA and Delayed Drug-Induced Hypersensitivity.
    Int Arch Allergy Immunol 2016 26;170(3):163-79. Epub 2016 Aug 26.
    Laboratory of Immunology, Basic and Clinical Immunology Unit, Faculty of Medicine, University of Porto, Porto, Portugal.
    Delayed drug allergy reactions (DDAR) are potentially fatal. Certain human leukocyte antigen (HLA) alleles have been associated with delayed allergy reactions following the administration of particular drugs. Examples are HLA-B*57:01 (abacavir), HLA-B*15:02/HLA-A*31:01 (carbamazepine), and HLA-B*58:01 (allopurinol). Read More

    Phase Ia/Ib study of the pan-class I PI3K inhibitor pictilisib (GDC-0941) administered as a single agent in Japanese patients with solid tumors and in combination in Japanese patients with non-squamous non-small cell lung cancer.
    Invest New Drugs 2017 Feb 27;35(1):37-46. Epub 2016 Aug 27.
    Department of Thoracic Medical Oncology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan.
    Pictilisib (GDC-0941) is an oral class I phosphatidylinositol-3-phosphate kinase inhibitor. This phase Ia/Ib study investigated the safety, tolerability, pharmacokinetics, and pharmacodynamics of pictilisib in monotherapy or in combination with carboplatin-paclitaxel and bevacizumab (CP + BEV) in Japanese patients with advanced solid tumors or non-squamous non-small cell lung cancer. A standard 3 + 3 dose escalation design was applied. Read More

    Evaluation of Lymphocyte Transformation Test Results in Patients with Delayed Hypersensitivity Reactions following the Use of Anticonvulsant Drugs.
    Int Arch Allergy Immunol 2016 25;170(3):158-62. Epub 2016 Aug 25.
    Department of Immunology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
    Background/aim: Administration of the anticonvulsant drugs phenobarbital, phenytoin, carbamazepine and lamotrigine can be associated with severe hypersensitivity reactions. The lymphocyte transformation test (LTT) is a method to determine which drug has caused the hypersensitivity reaction. This study was done to evaluate the results of LTT in patients with delayed hypersensitivity reactions following the administration of anticonvulsants. Read More

    Atypical pityriasis rosea: clinical evaluation of 27 patients.
    Cutan Ocul Toxicol 2016 Sep 26:1-6. Epub 2016 Sep 26.
    b Yildirim Beyazit University, Medical Faculty , Department of Dermatology , Ankara , Turkey.
    Background: Pityriasis rosea (PR) is a common, acute, self-limiting inflammatory skin disease. It can easily be recognized with its typical clinical presentation. However, unusual clinic presentations can cause difficulty in diagnosis. Read More

    Drug induced exfoliative dermatitis: state of the art.
    Clin Mol Allergy 2016 22;14. Epub 2016 Aug 22.
    Department of Allergy and Clinical Immunology, IRCCS San Raffaele Hospital, Via Olgettina 60, 20132 Milan, Italy ; Vita-Salute San Raffaele University, Milan, Italy.
    Drug induced exfoliative dermatitis (ED) are a group of rare and severe drug hypersensitivity reactions (DHR) involving skin and usually occurring from days to several weeks after drug exposure. Erythema multiforme (EM), Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are the main clinical presentations of drug induced ED. Overall, T cells are the central player of these immune-mediated drug reactions. Read More

    Serum TARC levels are strongly correlated with blood eosinophil count in patients with drug eruptions.
    Allergol Int 2017 Jan 4;66(1):116-122. Epub 2016 Aug 4.
    Department of Dermatology, Shimane University Faculty of Medicine, Shimane, Japan. Electronic address:
    Background: This study aims to evaluate the relationship between serum thymus and activation-regulated chemokine (TARC) levels with various clinicopathological conditions in patients with drug eruptions. The value of TARC in diagnosing drug-induced hypersensitivity syndrome (DIHS) was also examined.

    Methods: Study participants included 84 patients who presented with generalized eruptions suspected to be drug-related, including DIHS, Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN), maculopapular exanthema (MPE), erythema multiforme (EM), erythroderma, and toxicoderma. Read More

    [Terbinafine : Drug-induced lupus erythematodes and triggering of psoriatic skin lesions].
    Hautarzt 2016 Sep;67(9):724-31
    , Hofmannstr. 11, 35444, Biebertal, Deutschland.
    Based on the technical information that oral terbinafine must be used with caution in patients with pre-existing psoriasis or lupus erythematosus, the literature was summarized. Terbinafine belongs to the drugs able to induce subcutaneous lupus erythematosus (SCLE)-with a relatively high risk. The clinical picture of terbinafine-induced SCLE may be highly variable and can also include erythema exsudativum multiforme-like or bullous lesions. Read More

    Non-haemorrhagic, bilateral adrenal infarction in a patient with antiphospholipid syndrome along with lupus myocarditis.
    BMJ Case Rep 2016 Jul 20;2016. Epub 2016 Jul 20.
    Department of Surgery, London North West Healthcare Trust, Ealing, UK.
    A 40-year-old woman with antiphospholipid syndrome presented with a 5-day history of right upper quadrant (RUQ) pain, radiating posteriorly, associated with fever and vomiting. She was admitted 1-week prior with an upper respiratory infection and erythema multiforme. Clinical assessment revealed sepsis with RUQ tenderness and positive Murphy's sign. Read More

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