Mucocutaneous Eruptions in Acutely Ill Pediatric Patients—Think of <i>Mycoplasma pneumoniae</i> (and Other Infections) First

Ramien, Michele; Bruckner, Anna L.

doi:10.1001/jamadermatol.2019.3589

Cited by 41 publications

(47 citation statements)

References 15 publications

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“…Discussion | Formerly known as Mycoplasma-induced rash and mucositis, RIME has arisen as the preferred terminology to include mucocutaneous eruptions that are caused by other infectious agents. 2 This case describes RIME secondary to SARS-CoV-2 infection, details its resolution with systemic steroids, and notes the potential for recurrence with subsequent milder symptoms, as has been previously reported. 3 The combination of anosmia and ageusia, multiple positive SARS-CoV-2 PCR tests, and no other identified contemporaneous infections (the elevated Mycoplasma pneumoniae IgG titer with low IgM titer and negative nasopharyngeal PCR likely indicated prior exposure) suggests SARS-CoV-2 as the infectious trigger.…”

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confidence: 66%

Reactive Infectious Mucocutaneous Eruption Associated With SARS-CoV-2 Infection

et al. 2021

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Discussion | The patient's PNP-like clinical features prompted us to investigate PNP-associated immunoreactivity and pursue a workup for internal malignancy. However, no malignancy was found, despite the detection of envoplakin and periplakin, well-known PNP autoantigens of the plakin family, using epidermal extract immunoblotting. In contrast, IF studies had negative results.Despite the absence of malignancy, the clinical features and results of immunoblotting in this patient were consistent with PNP. Negative results in direct and indirect IF studies may occur in PNP, 1 and negative IF results have also been reported in ocular mucous membrane pemphigoid, another blistering disease whose ocular lesions may resemble PNP. 2 In pemphigus, neutrophils and eosinophils infiltrate the bullae of the epidermis. Infiltration of numerous neutrophils in the epidermis, which was seen in this patient, is occasionally reported. 3 Thus, the histopathologic pustular appearance seen in this case is uncommon for pemphigus, but suggests a neutrophilic dermatosis. The mucocutaneous lesions appears to be consistent with an antiplakin autoantibody-associated eruption that we have termed antiplakin dermatosis. This may represent a new disease entity with a unique clinicopathologic presentation and autoantibody profile, a representor of clinical remembrance to PNP without underlying malignancy.It is unclear why sensitizations to envoplakin and periplakin were induced in this case. We hypothesize 3 possibilities: (1) spontaneous regression and disappearance of malignancy after sensitization to envoplakin and periplakin, (2) the presence of unidentified malignancy, and (3) occasional sensitization, as shown in drug hypersensitivity syndrome and Stevens-Johnson syndrome. 4 We should verify the sensitivity and specificity of the immunoblot assay for antiplakin antibodies for accuracy of diagnosis. The pathologic role of antibodies to envoplakin and periplakin in this patient remains unclear and should be examined by in vivo and ex vivo experiments.

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confidence: 66%

Reactive Infectious Mucocutaneous Eruption Associated With SARS-CoV-2 Infection

et al. 2021

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“…Cases that are considered RIME under this categorization are usually characterized by a severe mucositis of 2 or more mucous membranes, with a prodrome that usually includes a cough. 2 Cases that fall within the RIME category tend to be single occurrences in most patients. [3][4][5][6] However, there is a subset of patients with recurrent episodes estimated to be about 8% in a systematic review of cases with Mycoplasma pneumoniaeeassociated mucocutaneous disease.…”

Section: T He Pediatric Dermatology Researchmentioning

confidence: 99%

Recurrent Mycoplasma pneumoniae–associated reactive infectious mucocutaneous eruption responsive to systemic steroids: A case series

et al. 2021

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“…Adenovirus has also rarely been associated with SJS, but severe mucositis, as in our two patients, has not been previously described. 5 Kawasaki disease (KD) shares many clinical features with adenoviral infection; however, KD is not associated with oral erosions and ulcers ( Table 1) Jesus Moises Ramírez-López MD 3 Marco Antonio Yamazaki-Nakashimada MD 4 org/0000-0002-5156-8072…”

Section: Patientmentioning

confidence: 99%

“…Goyal et al 3 described two patients with influenza-induced rash and mucositis. Ramien et al 4 recently proposed the term RIME (reactive infectious mucocutaneous eruption) to unify the terminology for MIRM and other clinically similar mucosal-predominant para-infectious eruptions. We report two cases with clinical manifestations suggestive of RIME with documented adenovirus infection and without other infection.…”

Section: Introductionmentioning

confidence: 99%

Adenoviral‐induced rash and mucositis: Expanding the spectrum of reactive infectious mucocutaneous eruption

Gámez-González¹,

Peña-Varela²,

Ramírez-López³

et al. 2020

Pediatric Dermatology

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Mucocutaneous eruptions associated with respiratory pathogens, specifically Mycoplasma pneumoniae (MP), has recently been described as a MIRM (MP-induced rash and mucositis). The term reactive infectious mucocutaneous eruption (RIME) has been proposed, since non-MP pathogens may also cause a similar rash and mucositis. We report two cases with clinical manifestations suggestive of MIRM/RIME, both with documented adenovirus infection.

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Mucocutaneous Eruptions in Acutely Ill Pediatric Patients—Think of Mycoplasma pneumoniae (and Other Infections) First

Cited by 41 publications

References 15 publications

Reactive Infectious Mucocutaneous Eruption Associated With SARS-CoV-2 Infection

Reactive Infectious Mucocutaneous Eruption Associated With SARS-CoV-2 Infection

Recurrent Mycoplasma pneumoniae–associated reactive infectious mucocutaneous eruption responsive to systemic steroids: A case series

Adenoviral‐induced rash and mucositis: Expanding the spectrum of reactive infectious mucocutaneous eruption

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