What are the causes of erythema multiforme?

Causes of erythema multiforme:

  • Infections (at least 90% of cases):
    • Virus: Mostly by human herpes simplex virus.  But Many different virus infections have been reported to trigger erythema multiforme including: 
      • Parapoxvirus (orf and milkers’ nodules)
      • Herpes varicella-zoster (chickenpox, shingles)
      • Adenovirus
      • Hepatitis viruses
      • Human immunodeficiency virus (HIV)
      • Cytomegalovirus
      • Viral vaccines
    • Bacteria (Streptococcus, Mycoplasma, non‐tuberculous mycobacteria)
    • Tinea
    • Chlamydia
    • Rickettsia
  • Drugs:
    • Antibiotics (Penicillin, sulphonamides)
    • NSAID
    • Anticonvulsants (Barbiturates)
    • Phenothiazine
    • Antineoplastic agents
  • Allergic disorder:
    • Insect bite
  • Collage disease:
    • SLE
  • Other disease conditions:
    • Sarcoidosis
    • Crohn’s disease
    • Hematopoietic malignant disorders
  • Others:
    • Physical stimulant (e.g. cold)
    • Pregnancy
erythema multiforme (EM)

Sources:

  • Shimizu's Dermatology 2nd Edition; Table 9.1, page: 146
  • Rapid Review of Clinical Medicine for MRCP Part 2 Second Edition by Sanjay Sharma: Q 154
  • Dermatology Made Easy 1st Edition (2017): Chapter 3; Section 3.7


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