Erythema multiforme: A case report with oral manifestations

Abstract

Introduction: Erythema multiforme (EM) is an acute, immune-mediated mucocutaneous disease, which may be related to herpes simplex virus, use of certain medications, autoimmune disease, radiation, immunization, pregnancy, period, and food additives or chemicals. It is a condition that occurs predominantly in young adults, with a slight female preponderance and no predilection. Clinically, EM presents erosive and erythematous plaques, affecting mainly the lips and oral mucosa, called target lesions, which may progress to vesiculobullous lesions. The aim of this study is to report a case shown as a positive response to treatment. Case Report: This is a case of EM in a 50-year-old female patient with a persistent ulcer on the lower lip. The clinical presentation showed an ulcerated lesion that extended through the right labial vermilion, semi-mucosa and jugal mucosa, in addition to painful symptoms. Although the diagnostic hypothesis of EM, an incisional biopsy was performed, that confirmed the clinical diagnosis of EM. As treatment, topical use of 0.05% clobetasol propionate for 15 days was prescribed on the lesion. The patient returned in seven days with significant improvement of the site. It was decided to do only the follow-up and not to intervene with systemic corticosteroid therapy. The patient is followed up for 15 months without recurrence of the lesion. The histopathological analysis of this type of lesion is essential for the diagnosis of the lesion. In this way, we can rule out differential diagnoses, especially pemphigus vulgaris and in children, hands, feet, and mouths disease. In this work, it was observed how important the histopathological analysis is necessary in more complex cases, because in this way the therapeutic approach was effective. Conclusion: The present case report represents how important the histopathological analysis is necessary in more complex cases to conclude the diagnosis, therefore is possible conduce the best choose of treatment for patient.