The Association Between Allergic Contact Dermatitis and Erythema Multiforme: A Systematic Review of the Literature

Abstract

The relationship between erythema multiforme (EM) and allergic contact dermatitis (ACD) remains unclear. There have been multiple reports of EM-like lesions occurring in conjunction with or presenting after ACD; however, various definitions and terminologies have been used to denote the patient's diagnosis in these cases. In this systematic review, we summarize the key presenting features of recent cases of EM-like eruptions associated with ACD, as well as diagnostic findings, responsible allergens, treatments, and outcomes. We propose that, whenever possible, these cases should be classified into 2 distinct categories: (1) EM-like ACD and (2) EM after ACD (ACD-induced EM). Because the clinical courses, potential complications, and treatment plans differ between the two, a critical need exists for further characterization and distinguishment of EM-like ACD and ACD-induced EM.

Erythema multiforme‐like allergic contact dermatitis from bay leaves in a home‐made natural remedy

“…Plants, perceived by the consumers as inoffensive, are common elicitors of erythema multiforme (EM)‐like contact dermatitis (CD), a non‐eczematous variant 2,3 of allergic CD, whereby combined features of EM and eczema may coexist.…”

Cases from a Community Hospital…JCHIMP Series #2: 66-Year-Old Man with Recurrent Painful Rashes and Oral Ulcerations

“…Other etiologies identified include non HSV infection (EBV, HCV and influenza, Mycoplasma SARS-COV-2), medications (penicillin, NSAIDs, sulfonamides, and anti-epileptics) immunizations, autoimmune conditions, sarcoidosis, radiation, allergic contact dermatitis while a large number remain idiopathic. 6 , 8 – 16 In HSV related EM, viral antigens are hypothesized to be deposited in skin which triggers a cell mediated immune response. CD4+ Th1 cells are then recruited with interferon-gamma (IFN-γ) produced which initiates downstream increased monocytes and natural killer cells production to target the HSV antigen.…”