Abstract
Erythema Multiforme is an acute, self- limiting inflammatory mucocutaneous condition caused by a hypersensitivity reaction with distinctive clinical eruption manifested as iris or target lesions. It is a life-threatening mucocutaneous disorder where early diagnosis and management are of utmost importance. Erythema Multiforme results from a cell-mediated immune reaction against a precipitating factor. It is clinically characterized by a ‘‘minor'' form and a ‘‘major'' form. In the Erythema Multiforme minor, only one mucous membrane is affected and usually is the oral mucosa. Erythema Multiforme is diagnosed based on stringent clinical findings which are pathognomic as microscopic evaluation carries the least significance. The range of possible etiologies for the oral disease is immense including infectious agents, drugs, food additives, etc. We report a case of a 68-year-old female who presented with a complaint of painful ulcers and burning sensation in her mouth making her difficult to eat & drink. History revealed the usage of clove to get rid of tooth pain following which she developed ulcers in the mouth. In the present case, based on patient history, the clove was found to be a probable etiological agent. The patient was successfully treated with corticosteroids adhering to systemic corticosteroid administrative protocols and no remissions and exacerbations were noticed in 6 months follow up. Early diagnosis of the disease remains essential to promptly initiate appropriate management and proper follow up. Recognition and withdrawal or prevention of contact with the etiological agent is an important step in the management of EM. In the present case, the clove was found to be a probable etiological agent.
Highlights
Erythema multiforme (EM) is an intense, self‐limiting, sometimes recurrent mucocutaneous disorder that manifests with a reaction pattern that appears as a consequence of allergic host response to an antigenic challenge
We present a case of condiment induced EM minor and believe that the inducing agent is clove which is otherwise used for relief from tooth pain
Erythema multiforme being a reactive ulcerative lesion is multifactorial in origin
Summary
Erythema multiforme (EM) is an intense, self‐limiting, sometimes recurrent mucocutaneous disorder that manifests with a reaction pattern that appears as a consequence of allergic host response to an antigenic challenge. The exact pathogenesis of EM is still unknown and it has been postulated that EM results from T-cell-mediated immune reaction to the precipitating etiological agent leading to a cytotoxic immunological attack on keratinocytes that express non-self-antigens causing vesicles, blisters and erosions [3]. It is a disease of abrupt onset involving skin and mucous membranes where the lesions appear as red macules, papules, and vesicles. Diffuse redness and multiple small macules (lower labial mucosa) were noticed. (Figure 3)
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