Erythema multiforme revisited: a follow-up report of two patients with bipolar disorder

ABSTRACT

The hypersensitivity mucocutaneous disorders within the spectrum of erythema multiforme [EM] are characterized by salient features, caused by multiple etiologies, and associated with 1% to 50% mortality. The objective of this paper is to describe the follow-up course of two bipolar patients who had previous episodes of carbamazepine-induced EM. During their in-patient treatment it was observed that once again these two patients developed spectrum of EM in case 1 erythema multiforme major [EMM] temporally induced by chlorpromazine [CPZ] while in case 2, EMM and toxic epidermal necrolysis [TEN] for which the etiological factor remained questionably identified. Besides, discussing the most relevant points including comparative phenomenology, possible etiological agents, complications, and histopathological findings in relation to hese cases, it was tentatively concluded that the drugs known to cause EM should be avoided to the maximum extent in those patients who had previous history of EM