Erythema multiforme major with ocular involvement following COVID-19 infection

Abstract

We report a case of membranous conjunctivitis and erythema multiforme major (EMM) after a coronavirus disease 2019 (COVID-19) diagnosis. A previously well 18-year-old man presented with increasingly erythematous eyes and oral and genital ulceration 2 weeks after confirmation of COVID-19 infection. Clinical examination showed sloughy membranous conjunctivitis with normal visual acuity. He was reviewed by dermatology and diagnosed with EMM secondary to severe acute respiratory syndrome coronavirus 2 infection. The symptoms resolved with oral and topical steroids, lubricants and chloramphenicol eye drops. Erythema multiforme has been reported in association with COVID-19, although the major form is rare. Ophthalmologists should consider current or previous COVID-19 infection in patients presenting with conjunctivitis or pseudomembrane formation. Prompt initiation of steroids aids resolution.

Virological Characterization of Pigs with Erythema Multiforme

“…Erythema multiforme is a multifactorial disease described for humans [ 1 , 24 , 25 ], pigs [ 3 , 4 , 5 , 6 ], dogs [ 7 ] and wild animals, such as ferrets and spotted hyenas [ 8 , 9 ]. The most studied risk factors are drugs, bacterial, viral and fungal infections and/or stress.…”

“…Pediatric erythema multiforme was most commonly attributed to upper respiratory and Mycoplasma pneumoniae infections, whereas adult erythema multiforme was mainly assigned to HSV infections [ 28 ]. Since the SARS-CoV-2 pandemic, numerous cases of erythema multiforme in infected patients have been reported [ 23 , 24 , 29 ]. Erythema multiforme cases were reported after vaccination against the coronavirus, as well as after other vaccinations [ 30 , 31 , 32 ].…”