title: Paediatric Erythema Multiforme: Epidemiological, Clinical and Laboratory Characteristics.
abstract: 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 Most studies utilize the outdated classification, which includes EM, Stevens-Johnson syndrome and toxic epidermal necrolysis as related entities.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. This is a retrospective single-centre study, performed between 2000 and 2013. Of 119 children given a diagnosis of EM, only 30 met clinical criteria and were included in this study. Most misdiagnosed cases were non-specific eruptions and urticaria multiforme. Mean age was 11.3 years. Fifty percent had mucosal involvement. An aetiology was observed in half of the patients. Seventy percent of patients were admitted to hospital, 46.7% were treated with systemic steroids. Sixteen percent had recurrent EM. The most common identified infectious agent associated with EM in this study was Mycoplasma pneumonia and the cases associated with this infection may represent the recent entity, mycoplasma-induced rash and mucositis. Association with herpes simplex virus was not observed. Despite being a benign, self-limiting condition, children were over-treated in terms of hospitalization and therapy.
authors.affiliation: Pediatric Division, Hadassah-Hebrew University Medical Center, 91120 Jerusalem, Israel. weinyael@gmail.com.
authors.forename: Yael
authors.initials: Y
authors.lastname: Siedner-Weintraub
authors.forename: Itai
authors.initials: I
authors.lastname: Gross
authors.forename: Almog
authors.initials: A
authors.lastname: David
authors.forename: Shimon
authors.initials: S
authors.lastname: Reif
authors.forename: Vered
authors.initials: V
authors.lastname: Molho-Pessach
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D004892:Erythema Multiforme / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D006760:Hospitalization; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D000069342:Medical Overuse; D011019:Pneumonia, Mycoplasma / Q000175:diagnosis / Q000453:epidemiology; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D009626:Terminology as Topic; D016896:Treatment Outcome