並列摘要
Erythema multiforme (EM) is an acute mucocutaneous disease which has been associated with herpes simplex virus (HSV) infection, drugs, and Chinese herbal medicine. This report presents a case of EM with a delayed diagnosis and improper treatment. A 28-year-old female patient came to our oral medicine clinic with a chief complaint of multiple oral ulcerations for more than 3 months. She was treated as having an HSV infection or candidiasis, but the oral lesions did not improve after treatment. An intraoral examination showed multiple large ulcers on the bilateral lateral borders and ventral surface of the tongue, bilateral buccal mucosae, and lingual frenum. No ”target” lesion was found on the skin surface of her body or extremities. An incisional biopsy of the tongue tip was performed. The hematoxylin and eosin-stained tissue section demonstrated focal surface ulceration, an intraepithelial vesicle in the upper spinous layer, an intense chronic inflammatory cell infiltrate in the lamina propria, and a perivascular inflammatory infiltrate in the submucosa. Although the histopathologic features were not pathognomonic, they were characteristic for a diagnosis of EM. The patient was treated with 10 mg prednisolone 3 times daily for 7 days. A follow-up oral examination revealed that all oral ulcers had completely cleared up after the 7-day corticosteroid treatment. One year after treatment, the patient remained disease-free. We concluded that EM is a mucocutaneous disease that requires a prompt and precise diagnosis. Once the disease is confirmed by the clinical presentation or a histopathological examination of an incisional biopsy specimen, it usually dramatically responds to treatment with a medium or high dose of corticosteroids.
延伸閱讀
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