Mucosal erosions as the presenting symptom in erythema multiforme: a case report

Abstract

Erythema multiforme (EM) is an acute and self-limiting hypersensitivity reaction. This article describes the case of a patient who suffered from a chest infection and later presented with the mucosal manifestations of EM. This condition manifests as skin lesions, most commonly in reaction to herpes simplex virus (HSV) 1 and 2, Mycoplasma pneumoniae , or certain medications.1 A 31-year-old male patient presented to his GP with cough and fever, sores in his mouth, and itchy eyes. He had not received any medical attention prior to this appointment, nor had he taken any recent medications. He was initially prescribed aciclovir to treat oral herpes simplex infection, amoxicillin for chest infection, and chloramphenicol for conjunctivitis. Two weeks later he was seen by the medical assessment unit. In addition to blisters on his mouth and lips (Figure 1), he developed pruritic blisters on his penis and foreskin (Figure 2), small lesions acrally, and red eyes. On this basis the consultant medical physician referred the patient to the genitourinary medicine (GUM) clinic to rule out sexually-acquired reactive arthritis (SARA) secondary to chlamydia infection. Figure 1. Erosions of the oral mucosa in a case of erythema multiforme. Figure 2. Erythema multiforme-associated …