Recurrent Erythema Multiforme/Stevens-Johnson Syndrome

Recurrent erythema multiforme: Clinical characteristics, etiologic associations, and treatment in a series of 48 patients at Mayo Clinic, 2000 to 2007

“…The results of previous studies have shown the efficacy of corticosteroids in the treatment of recurrent oral EM, 22 but other investigators maintain that such therapy only partially suppresses disease and may lead to disease chronicity and prolonged duration of attacks. 6,8 Therapies other than corticosteroids that have been reported to be beneficial in recurrent EM include continuous antiviral medications, 1,8,23 dapsone, 1 azathioprine, 1,6 intramuscularly administered human immunoglobulin, 1,5 hydroxychloroquine, 1 cyclosporine, 24 mycophenolate mofetil, 25 thalidomide, 26,27 interferon alfa (in cases secondary to hepatitis C virus infection 14,15 ), and cimetidine. 28 Tatnall et al 8 performed a double-blind, placebocontrolled trial of continuous acyclovir therapy (6 months) in 20 patients with recurrent EM (15 had HSV-induced disease).…”

Erythema multiforme, Stevens–Johnson syndrome and toxic epidermal necrolysis: a comparative review

“…However, in older lesions of HAEM or in bullous EM (Figure a), full‐thickness epidermal necrosis may mimic SJS/TEN (Figure b). The lesions illustrated in some cases of recurrent and persistent EM have superficially located apoptotic keratinocytes (‘dyskeratotic’ cells), with overlying parakeratosis and lesser involvement of the basal layer . Lymphocytic perivascular dermatitis affects superficial and mid‐level plexii (Figure a) (in contrast to fixed drug eruptions, in which deep plexii are involved).…”

Mycophenolate mofetil in dermatology

“…100-102 MMF has also been used successfully to treat both erythema multiforme and erythema nodosum. 103,104 Furthermore, MMF has been found to treat various cutaneous manifestations of Crohn disease, including Crohn-associated pyoderma gangrenosum. [105][106][107] Numerous other cases of pyoderma gangrenosum have also responded well to MMF.…”