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KMID : 0371619990150010001
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Journal of Wonkwang Medical Science
1999 Volume.15 No. 1 p.1 ~ p.7
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Erythema Multiforme, Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis : A retrospective clinico-histopathologic study
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Cha Seung-Hoon
Jeong Sang-Won
Park Seok-Don
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Abstract
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Background: Erythema multiforme (EM) is an acute self-limited disease with distinctive skin lesion. Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) has been regarded as variants of EM within continuous spectrum. The reports that EM with mucous membrane involvement and SJS are clinically different disorders prompt us to investigate the relationship between clinical features and causative factors of these dermatoses.
Methods: A retrospective clinico-histopathologic study was performed in 59 patients from 1988 to 1996.
Results: While most of EM patients showed typical target, raised atypical target, or flat atypical target, purpura with or without blistering was noted in 80% of SJS patients and all of TEN patients. In EM patients, the skin eruption was mainly located acrally or centrally, diffuse involvement was observed in all of TEN patient. The involved skin surface area was wider in SJS and TEN than EM. Through the review of histopathologic slides, we found that 74% (17/23) was inflammatory type which was diagnosed as EM in 76% patients. Drug was the most common causative factor (41%), and there were the clinical evidences of recurrent herpes simplex virus infection in 12% (7/59) patients.
Conclusion: We conclude that there is no difference in clinical features of EM, SJS, and TEN compared with reported studies. A detailed and precise prospective study is necessary to elucidate the clinical features and etiology of these unique dermatoses.
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KEYWORD
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Erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis, drug, herpes simplex virus
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