Abstract
Introduction. Erythema multiforme major (EMM) is an acute, immune-mediated type
IV hypersensitivity reaction, often triggered by HSV. It presents with macular, papular or bullous
lesions that evolve into characteristic “target lesions” and involves mucosal surfaces and may result
in significant morbidity.
Case description. A 16-year-old female presents with recurrent painful rashes on her hands,
feet, and mouth, along with oral and lip ulcers. Symptoms first appeared in 2019 and recurred in June
2024. Dermatologist consultation in January 2022 followed similar episodes and treatment. Blood
tests (April 2022): Anti-HSV Av negative, Anti-EBV IgG positive, Anti-EBV VCA IgM borderline.
Treated with Isoprinosine. During a visit to Egypt in 2023, symptoms recurred and improved with
Prednisolone. Blood tests (June 2023): Anti-EBV IgG positive, Anti-EBV VCA IgM borderline, Anti
HSV 1/2 and VZV Av positive. Treatment included Acyclovir (400 mg twice daily for six months)
and Dexamethasone, later switched to Methylprednisolone (July–September 2023). In October 2023,
ulcers reappeared when Acyclovir was briefly stopped, prompting continuation of Acyclovir through
February 2024. The patient remains on Acyclovir (400 mg twice daily) since June 2024.
Summary. This clinical case represents a paediatric patient with recurrent Erythema
multiforme, it is a first case of recurrent pediatric EMM in the Children Clinical University Hospital
of Riga, Latvia.
Conclusions. Recurrence of Erythema multiforme major is a rare finding in paediatric patients.
At the moment the precautions had been taken of prolonged use of Acyclovir and the question of the
duration of the therapy to control the disease exacerbations still stands.
IV hypersensitivity reaction, often triggered by HSV. It presents with macular, papular or bullous
lesions that evolve into characteristic “target lesions” and involves mucosal surfaces and may result
in significant morbidity.
Case description. A 16-year-old female presents with recurrent painful rashes on her hands,
feet, and mouth, along with oral and lip ulcers. Symptoms first appeared in 2019 and recurred in June
2024. Dermatologist consultation in January 2022 followed similar episodes and treatment. Blood
tests (April 2022): Anti-HSV Av negative, Anti-EBV IgG positive, Anti-EBV VCA IgM borderline.
Treated with Isoprinosine. During a visit to Egypt in 2023, symptoms recurred and improved with
Prednisolone. Blood tests (June 2023): Anti-EBV IgG positive, Anti-EBV VCA IgM borderline, Anti
HSV 1/2 and VZV Av positive. Treatment included Acyclovir (400 mg twice daily for six months)
and Dexamethasone, later switched to Methylprednisolone (July–September 2023). In October 2023,
ulcers reappeared when Acyclovir was briefly stopped, prompting continuation of Acyclovir through
February 2024. The patient remains on Acyclovir (400 mg twice daily) since June 2024.
Summary. This clinical case represents a paediatric patient with recurrent Erythema
multiforme, it is a first case of recurrent pediatric EMM in the Children Clinical University Hospital
of Riga, Latvia.
Conclusions. Recurrence of Erythema multiforme major is a rare finding in paediatric patients.
At the moment the precautions had been taken of prolonged use of Acyclovir and the question of the
duration of the therapy to control the disease exacerbations still stands.
| Original language | English |
|---|---|
| Pages | 472 |
| Publication status | Published - 2025 |
| Event | 11th annual RSU International Students' Conference in Health and Social Sciences 2025 - Dzirciema 16, Riga, Latvia Duration: 24 Mar 2025 → 25 Mar 2025 Conference number: 11 https://isc.rsu.lv/ |
Conference
| Conference | 11th annual RSU International Students' Conference in Health and Social Sciences 2025 |
|---|---|
| Abbreviated title | RSU ISC 2025 |
| Country/Territory | Latvia |
| City | Riga |
| Period | 24/03/25 → 25/03/25 |
| Internet address |
Keywords*
- Erythema multiforme major
- Paediatrics
- Dermatology
Field of Science*
- 3.2 Clinical medicine
Publication Type*
- 3.4. Other publications in conference proceedings (including local)