Erythema multiforme in children: unusual clinical features with seasonal occurrence.

Eighty-six cases of erythema multiforme (EM) were studied based on the distribution of skin lesions. Twenty-nine patients had distinct facial skin lesions as well as lesions on the extremities (Group A) and 57 patients had skin lesions only on the extremities (Group B). Patients in Group A were younger than those in Group B; the average ages being 7.5 and 25.2 years, respectively. In Group A, the disease occurred mainly in winter, while, in Group B, it began most frequently in summer. Preceding ulcerated pernio was seen in 11 patients of Group A, but only one of Group B. Histopathologically, both groups are compatible with a diagnosis of EM, although the seasonal occurrence of facial involvement in Group A may suggest a specific etiological relationship to cold.