VIRUS-INDUCED ERYTHEMA MULTIFORME AND STEVENS-JOHNSON-SYNDROME

Erythema Multiforme is an acute, self-limited inflammatory cutaneous d isorder characterized by distinctive target lesions. Stevens-Johnson s yndrome (SJS) is defined as severe erythema multiforme with mucosal in volvement, visceral involvement, or both. Both diseases are part of a continuum of immunologically mediated mucocutaneous diseases at variou s grades of severity. Viral infections are known triggers of these ski n disorders. We report the success of a management strategy of acyclov ir and prednisone for herpes simplex virus-associated erythema multifo rme. In addition we describe the apparent first case of primary varice lla infection as a direct cause of SJS. The two cases are presented an d a single-case statistical analysis has been employed to evaluate the significance of the management protocol. The method of analysis is pr esented in the appendix. When a patient with primary varicella infecti on develops bullous lesions, SJS should be considered in the different ial diagnosis, as early and intense corticosteroid therapy may be life -saving. A regimen of prophylactic acyclovir and therapy for art exace rbation of herpetic lesions with acyclovir and prednisone was effectiv e in inducing significant control of recurrent erythema multiforme sec ondary to herpes simplex in our patient.