5-Minute Clinical Consult: Erythema Multiforme

Erythema Multiforme

Etiology

Most cases appear to be due to a preceding infection. Viral infections, particularly herpes simplex; also Epstein-Barr, Coxsackie, echovirus, varicella, mumps, and poliovirus
Bacterial infections, including brucellosis, diphtheria, borreliosis
Mycoplasma appears to more often precede Stevens-Johnson syndrome.
Protozoan infections
Fungal infection, including Trichophyton rubrum
Collagen vascular diseases
Malignancy
Pregnancy
Premenstrual hormone changes
Consumption of beer
Reiter syndrome
Sarcoidosis
Vaccines: Tetanus/Diphtheria, bacillus Calmette-Guérin, oral polio vaccine
Medications: Drugs seem to be an infrequent cause of erythema
The list of drugs that have been reported as being involved includes sulfonamides, penicillins, anticonvulsants, and salicylates, but most of these were actually associated with Stevens Johnson syndrome when it was considered to be a type of erythema nodosum major.

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