Clinical and histologic features of Mycoplasma pneumoniae–related erythema multiforme: A single-center series of 33 cases compared with 100 cases induced by other causes - 18/06/18
, Nicolas Ortonne, MD, PhD d, e, Touda Bounfour, MD a, Sabine Pereyre, MD, PhD f, g, Frédéric Schlemmer, MD, PhD h, Emilie Bequignon, MD i, Gérard Royer, MD j, Pierre Wolkenstein, MD, PhD a, b, c, e, Olivier Chosidow, MD, PhD a, b, c, eAbstract |
Background |
Mycoplasma pneumoniae infection has been documented in erythema multiforme (EM) and Stevens-Johnson syndrome–toxic epidermal necrosis (SJS-TEN). Clinical aspects of M pneumoniae–related EM have been poorly described in the literature.
Objective |
To highlight differences between M pneumoniae EM and non–M pneumoniae EM.
Methods |
This single-center, retrospective cohort study included all patients admitted to our dermatology department for EM during 2000-2015. We compared epidemiologic, clinical, and histologic data and follow-up for M pneumoniae EM and non–M pneumoniae EM cases.
Results |
Thirty-three patients with M pneumoniae EM were compared with 100 patients with non–M pneumoniae EM. Disease onset in winter was more frequent with M pneumoniae EM (P = .003). Acrally distributed lesions (32% vs 88%, P < .0001) and typical targets (45% vs 74%, P = .01) were less common in M pneumoniae EM than non–M pneumoniae EM. Multiple (≥2) mucousal membrane involvement was more frequent in M pneumoniae EM than non–M pneumoniae EM (97% vs 60%; P < .0001), as were mucosal and respiratory tract sequelae (P < .05). The mean hospital stay was longer with M pneumoniae EM patients: 9.5 days versus 5.1 days (P = .0002). A TEN-like pattern was observed in all 14 (100%) M pneumoniae EM skin biopsies versus 10 of 27 (48%) non–M pneumoniae EM biopsies (P < .001).
Limitations |
The retrospective design.
Conclusion |
M pneumoniae EM has a distinctive presentation compared with non–M pneumoniae EM, with more diffuse and atypical targets, more mucositis and respiratory tract sequelae. Histologic data show a TEN-like pattern in all M pneumoniae EM skin samples.
Le texte complet de cet article est disponible en PDF.Key words : atypical targets, clinical, erythema multiforme, histological, Mycoplasma pneumoniae, mucositis, presentation, sequelae
Abbreviations used : EM, HSV, MIRM, SJS, SJS-TEN, TEN
Plan
| Drs Amode, Ingen-Housz-Oro, Wolkenstein, and Chosidow contributed to this work equally. |
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| Funding sources: None. |
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| Conflicts of interest: None disclosed. |
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| Reprints not available from the authors. |
Vol 79 - N° 1
P. 110-117 - juillet 2018 Retour au numéro
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