RECURRENT ERYTHEMA MULTIFORME - CLINICAL-FEATURES AND TREATMENT IN A LARGE SERIES OF PATIENTS

Recurrent erythema multiforme is an uncommon disorder. We have reviewe d the clinical features and treatment of 65 patients with this conditi on. The mean number of attacks per year was six (range 2-24), and the mean duration of the disease was 9.5 years (range 2-3 6) reflecting it s chronicity. The majority of patients had oral mucous membrane involv ement (69%). In 46 patients (71%) the condition was precipitated by a preceding herpes simplex virus infection. Acyclovir was found to be th e most useful first-line treatment, with 55% of patients deriving bene fit from either continuous oral acyclovir or a patient-initiated 5-day oral course at the onset of herpes simplex virus infection. Of those failing to respond to acyclovir. a small proportion responded to dapso ne. The most resistant patients (11) were treated with azathioprine, w ith complete disease suppression in all cases.