CORTICOSTEROID TREATMENT OF ERYTHEMA MULTIFORME MAJOR (STEVENS-JOHNSON SYNDROME) IN CHILDREN

The effectiveness of systemic corticosteroids in erythema multiforme m ajor (EMM) is controversial. We therefore evaluated the efficacy of co rticosteroids in the treatment of EMM in a prospective study of 16 chi ldren with EMM admitted to our department within 3 days from the onset of rash. Ten patients (group A) received bolus infusions of methylpre dnisolone (4 mg/kg/day) while six had only supportive treatment (group B). The early use of corticosteroids compared to supportive treatment resulted in: (1) significant reduction of the period of fever (4.0 +/ - 1.9 vs 9.5 +/- 4.2 days P = 0.01); (2) reduction of the period of ac ute eruption (7.0 +/- 3.3 versus 9.8 +/- 3.0 days P = 0.08); and (3) m ilder signs of prostration. Complications were minimal in both groups. Conclusion The early and short course of corticosteroids favourably i nfluences the course of erythema multiforme major in children.