Background

Mycoplasma pneumoniae infection has been documented in erythema multiforme (EM) and Stevens-Johnson syndrome–toxic epidermal necrosis (SJS-TEN). Clinical aspects of M pneumoniae–related EM have been poorly described in the literature.

Objective

To highlight differences between M pneumoniae EM and non–M pneumoniae EM.

Methods

This single-center, retrospective cohort study included all patients admitted to our dermatology department for EM during 2000-2015. We compared epidemiologic, clinical, and histologic data and follow-up for M pneumoniae EM and non–M pneumoniae EM cases.

Results

Thirty-three patients with M pneumoniae EM were compared with 100 patients with non–M pneumoniae EM. Disease onset in winter was more frequent with M pneumoniae EM (P = .003). Acrally distributed lesions (32% vs 88%, P < .0001) and typical targets (45% vs 74%, P = .01) were less common in M pneumoniae EM than non–M pneumoniae EM. Multiple (≥2) mucousal membrane involvement was more frequent in M pneumoniae EM than non–M pneumoniae EM (97% vs 60%; P < .0001), as were mucosal and respiratory tract sequelae (P < .05). The mean hospital stay was longer with M pneumoniae EM patients: 9.5 days versus 5.1 days (P = .0002). A TEN-like pattern was observed in all 14 (100%) M pneumoniae EM skin biopsies versus 10 of 27 (48%) non–M pneumoniae EM biopsies (P < .001).

Limitations

The retrospective design.

Conclusion

M pneumoniae EM has a distinctive presentation compared with non–M pneumoniae EM, with more diffuse and atypical targets, more mucositis and respiratory tract sequelae. Histologic data show a TEN-like pattern in all M pneumoniae EM skin samples.

中文翻译：

---

肺炎支原体相关性多形性红斑的临床和组织学特征：单中心研究33例，其他原因引起的100例

背景

多形红斑（EM）和史蒂文斯-约翰逊综合征（Stevens-Johnson syndrome）-毒性表皮坏死（SJS-TEN）已被证明有肺炎支原体感染。文献中很少描述与肺炎支原体相关的EM的临床方面。

客观的

为了突出肺炎支原体和非肺炎支原体的区别。

方法

这项单中心，回顾性队列研究纳入了2000-2015年间我们皮肤科接受EM治疗的所有患者。我们比较了肺炎支原体和非肺炎支原体的流行病学，临床和组织学数据以及随访情况。

结果

将33例肺炎支原体EM患者与100例非肺炎支原体EM患者进行比较。冬季感染肺炎支原体EM更为常见（P  = .003）。Acrally分布病变（32％比88％，P  <0.0001）和典型目标（45％比74％，P  = 0.01）不太常见于肺炎支原体EM比非肺炎支原体EM。肺炎支原体肺炎多（≥2）粘膜受累比非肺炎支原体肺炎多（97％vs 60％；P  <.0001），以及粘膜和呼吸道后遗症（P <.05）。M型肺炎EM患者的平均住院时间更长：9.5天比5.1天（P  = .0002）。在所有14例（100％）肺炎性EM皮肤活检样本中均观察到TEN样模式，而27例（48％）非肺炎性EM肺活检样本中有10例（P  <.001）。

局限性

追溯设计。

结论

与非肺炎支原体EM相比，肺炎支原体EM具有独特的表现，具有更多的弥漫性和非典型性靶标，更多的粘膜炎和呼吸道后遗症。组织学数据显示所有肺炎支原体EM皮肤样本均呈TEN样模式。