CHARACTERISTICS OF THE ORAL LESIONS IN PATIENTS WITH CUTANEOUS RECURRENT ERYTHEMA MULTIFORME

Erythema multiforme may be recurrent and the oral cavity is often affe cted. A series of 82 patients with unequivocal recurrent cutaneous ery thema multiforme were examined to determine the incidence and nature o f oral lesions. Seventy per cent of patients had oral lesions, compris ing multiple, large, shallow, extremely painful and debilitating ulcer s, which affected the entire oral mucosa in over 20%. The buccal mucos a and tongue were the most frequently affected sites in the remainder and the lips were affected in 13% of patients. Lesions generally laste d for 1-3 weeks. In over 60% of cases these attacks followed an episod e of herpes simplex virus infection during the preceding fortnight. Re current attacks showed a different site distribution from the initial attacks. with a greater proportion having genital as well as skin and oral mucosal involvement. Detailed case histories of five patients are presented to illustrate the role of azathioprine in treating oral les ions and to document a familial case of recurrent erythema multiforme, with severe mucosal involvement.