In 1963, Rowellet al. described a syndrome combining lupus erythematosus (LE) and erythema multiforme (EM)-like lesions. In this report, we present a 15-year-old female who presented with both systemic LE and EM-like skin lesions meeting all of the major and one of the minor criteria for a diagnosis of Rowell syndrome. Her condition improved with administration of systemic and topical corticosteroids, and hydroxychloroquine. Rowell Syndrome, a rare entity, is often debated as a coincidental overlap of other conditions according to Bonciolini,et al.[1]In light of Rowell Syndrome's infrequency and the paucity of available literature, we emphasize the clinical significance of recognizing this challenging condition.

Introduction: Erythema multiforme has been known as an infection or drug-associated mucocutaneous eruption characterized by target lesions. A clinical entity, known as Mycoplasma-induced rash and mucositis seen mostly in the pediatric population is emerging and may be associated with atypical pneumonia caused by Mycoplasma pneumoniae. This presents with features overlapping with erythema multiforme and SJS-TEN spectrum but with a different trigger, prognosis, and recurrence rate. Case summary: Target lesions in the clinical setting are usually characteristically associated with erythema multiforme, a mucocutaneous condition associated with an underlying infectious trigger. We present a case of a 10-year-old Filipino boy who was initially diagnosed with erythema multiforme major. Eventual testing for the etiology of the underlying infection, Mycoplasma pneumoniae, proved to be a useful diagnostic that gave a better grasp on the case’s mechanism, sequela, and prognosis. The patient was admitted for pneumonia and his presenting mucositis was severe. Cutaneously, he had atypical target and few target lesions on the trunk and extremities. He was diagnosed as a case of Mycoplasma-induced rash and mucositis (MIRM) and treated with antibiotics and systemic steroids for which he recovered fully in three weeks. MIRM should be separated from erythema multiforme, Stevens Johnsons syndrome and toxic epidermal necrolysis as it follows a different disease course. Conclusion: Mycoplasma-induced rash and mucositis is now considered a distinct entity despite it having overlapping features with erythema multiforme and SJS-TEN spectrum. It presents usually in the younger age group with absent to sparse atypical vesiculobullous or targetoid lesions, significant mucosal involvement, and confluent necrosis on histology. It is important to identify it as a trigger because of its more frequent and severe mucosal sequelae. Management includes symptomatic relief, antibiotic therapy with a macrolide in the presence of pneumonia and systemic steroids when mucositis is severe. Majority of patients achieve full recovery.
Erythema Multiforme ; Mycoplasma pneumoniae ; Mucositis ; Exanthema

Urticaria multiforme is a cutaneous condition observed in children. This self-limited condition is characterized by well-circumscribed, annular, and erythematous wheals, which spontaneously disappear within a few days. Patients commonly present with acral edema and show a favorable response to antihistamines. It is frequently misdiagnosed as erythema multiforme or serum sickness-like reaction owing to distinctive annular wheals with an ecchymotic center observed in patients. This condition was previously known as acute annular urticaria. The term urticaria multiforme was introduced in 2007 to highlight this specific variant of urticaria. We describe 2 patients with acral edema and transient annular wheals with dusky red centers, which were diagnosed as urticaria multiforme lesions. To our knowledge, the Korean literature includes only a single case report describing acute annular urticaria. However, the report does not use the term ‘urticaria multiforme’ to describe this condition.
Child ; Edema ; Erythema Multiforme ; Histamine Antagonists ; Humans ; Pigmentation* ; Urticaria*

No abstract available.
Erythema Multiforme* ; Erythema* ; Pemphigoid, Bullous*

Autoimmune progesterone dermatitis is a rare cyclic premenstrual reaction to progesterone produced during the luteal phase of the menstrual cycle. The clinical symptoms of autoimmune progesterone dermatitis overlap with other forms of dermatosis such as erythema multiforme, eczema, fixed drug eruption, urticaria, and angioedema. We experienced 3 cases of autoimmune progesterone dermatitis. All patients had a recurrent history of monthly skin eruptions. Skin lesions normally began a few days before menstruation and resolved a few days later. Patients were confirmed to have autoimmune progesterone dermatitis by the results of the progesterone intradermal test. All three patients had different clinical findings such as erythema annulare centrifugum, urticaria, contact dermatitis, and rosacea. Because patients presented with variable clinical manifestations, they could have been easily misdiagnosed. The patients were treated with oral contraceptive, antihistamine and steroids for symptom control. We propose that dermatologists should consider autoimmune progesterone dermatitis in cases of recurrent cyclic skin eruptions in female patients. Further, if this condition is suspected, thorough history taking including that on menstrual cycle and intradermal progesterone test should be performed.
Angioedema ; Dermatitis* ; Dermatitis, Contact ; Drug Eruptions ; Eczema ; Erythema ; Erythema Multiforme ; Female ; Humans ; Intradermal Tests ; Luteal Phase ; Menstrual Cycle ; Menstruation ; Progesterone* ; Rosacea ; Skin ; Skin Diseases ; Steroids ; Urticaria

Mycoplasma pneumoniae (M. pneumoniae) is one of the most common causes of respiratory tract infections in pediatric and adult populations worldwide. M. pneumoniae is also associated with extrapulmonary complications, such as mucocutaneous eruptions. In dermatologic disorders, M. pneumoniae infection is known to be associated with erythema multiforme and Stevens-Johnson syndrome in children and young adults. Recently, several cases with M. pneumoniae-associated mucositis, which lacks typical target lesions, have been reported. The term Mycoplasma-induced rash and mucositis was suggested as a revised version of the term, Mycoplasma pneumoniae-associated mucocutaneous disease, which previously included erythema multiforme and Stevens-Johnsons syndrome. This revision helps to distinguish Mycoplasma-induced rash and mucositis, which has a distinct morphology, mild disease course, and potentially important clinical implications regarding treatment. Herein, we report a patient with Mycoplasma-induced rash and mucositis.
Adult ; Child ; Erythema Multiforme ; Exanthema* ; Humans ; Mucositis* ; Mycoplasma pneumoniae ; Mycoplasma* ; Pneumonia ; Pneumonia, Mycoplasma ; Respiratory Tract Infections ; Stevens-Johnson Syndrome ; Young Adult

Sorafenib is an oral, multi-targeted tyrosine kinase inhibitor with anti-angiogenic and anti-proliferative activity. It is approved for the treatment of unresectable hepatocellular and advanced renal carcinomas. Cutaneous toxicity is relatively common in patients receiving sorafenib. The most frequent cutaneous side effect is the hand-foot syndrome. Other adverse skin reactions include facial erythema, acral erythema, erythema multiforme, subungual splinter hemorrhage, stomatitis, and alopecia. In Korea, two cases of scrotal and perianal dermatitis after sorafenib therapy were reported. We report a 54-year-old male patient with a 2-week history of scrotal eczema who had been treated for chronic hepatitis type B, liver cirrhosis, and hepatocellular carcinoma. After 2 weeks of oral sorafenib (800 mg/day) administration, thick, scaly patches appeared on his scrotum. A skin biopsy specimen from these lesions revealed superficial dermal perivascular lymphocytic and neutrophilic infiltration, and dilatation of the lymphatics in the superficial dermis. The lesions improved after treatment with a topical and systemic steroid for 2 weeks. Herein, we report a rare case of scrotal erythema associated with sorafenib.
Alopecia ; Biopsy ; Carcinoma, Hepatocellular* ; Dermatitis ; Dermis ; Dilatation ; Eczema ; Erythema Multiforme ; Erythema* ; Hand-Foot Syndrome ; Hemorrhage ; Hepatitis, Chronic ; Humans ; Korea ; Liver Cirrhosis ; Male ; Middle Aged ; Neutrophils ; Protein-Tyrosine Kinases ; Scrotum ; Skin ; Stomatitis

No abstract available.
Cluster Headache* ; Erythema Multiforme* ; Erythema* ; Herpes Simplex

Autoimmune progesterone dermatitis is a rare disorder involving hypersensitivity to progesterone. It is most frequently characterized by recurrent erythema multiforme, eczematous or urticarial eruptions during the luteal phase of the menstrual cycle. It resolves or partially improves after menstruation. Sensitivity is demonstrated by a challenge test with medroxyprogesterone acetate. The therapeutic goal for autoimmune progesterone dermatitis is the suppression of ovulation. Currently, the first-line choice of therapy is a combination oral contraceptive. Here, we report a case of autoimmune progesterone dermatitis that manifested as cyclic bullous erythema multiforme. A reactive intradermal progesterone test confirmed the diagnosis.
Dermatitis* ; Diagnosis ; Erythema Multiforme* ; Erythema* ; Female ; Hypersensitivity ; Luteal Phase ; Medroxyprogesterone Acetate ; Menstrual Cycle ; Menstruation ; Ovulation ; Progesterone*

No abstract available.
Erythema Multiforme* ; Erythema* ; Recurrence* ; Imatinib Mesylate