A case of recurrent erythema multiforme and its therapeutic complications.

INTRODUCTION

We report a patient with recurrent erythema multiforme (recurrent EM) who developed iatrogenic Cushing's syndrome due to prolonged corticosteroid use.

CLINICAL PICTURE: The patient had been treated with multiple courses of oral and intramuscular prednisolone over a 10-year period to suppress his recurrent and episodic symptoms. This resulted in the development of iatrogenic Cushing's syndrome with secondary adrenal suppression and steroid-induced osteoporosis.

TREATMENT: The patient was treated with continuous acyclovir therapy in addition to azathioprine. This combination controlled his disease and enabled us to stop his requirement for high-dose prednisolone.

OUTCOME: The patient responded well to this treatment regimen and has been in remission to date.

CONCLUSION

This represents a severe case of recurrent EM and the side effects associated with years of chronic high-dose steroid usage. We discuss the therapeutic options to aid physicians in treating this disabling condition.