Muñoz-Cruzado Rosete A, Carazo-Gallego B, Galindo-Zavala R, Martín-Pedraz L, Moreno-Pérez D

Language: Spanish
References: 10
Page: 263-269
PDF size: 349.09 Kb.

ABSTRACT

Introduction: Mycoplasma pneumoniae-induced rash and mucositis (MIRM) is a different disease from Stevens-Johnson syndrome (SJS) and erythema multiforme (EM), presenting mainly in adolescents in whom mucosal involvement predominates over the skin.
Objective: To describe our experience of pediatric patients with MIRM.
Material and Methods: Retrospective descriptive study in children under the age of 14 with MIRM between 2015 and 2020.
Results: 6 patients were diagnosed, 5 between January and April 2019. In 5 cases there was involvement of the ocular, pharyngeal and urogenital mucosa. Vesiculo-bullous skin lesions were predominant. M. pneumoniae was isolated in all the patients. Due to mucosal involvement, 4 patients required parenteral nutrition and 3 required urinary catheterization. Immunomodulatory treatment with systemic corticosteroids and intravenous immunoglobulin was prescribed in 5 cases. The evolution was favorable and the most frequent sequel was xerophthalmia.
Conclusion: Despite the clinical similarity between EMIM and SJS or EM, it should be suspected in adolescents with predominance of mucosal involvement. The evolution of our patients was favorable with supportive treatment and an immunomodulator, although well-designed studies are necessary to establish which patients require treatment with corticosteroids and/or immunoglobulin.

REFERENCES

1. Ramien M, Goldman JL, Bellón T. Pediatric SJS-TEN:Where are we now? [version 1; peer review: 2 approved].F1000Research2020,9(Faculty Rev). 2020;9:1-11.

2. Canavan TN, Mathes EF, Frieden I, Shinkai K. Mycoplasmapneumoniae-induced rash and mucositis as a syndromedistinct from Stevens-Johnson syndrome and erythemamultiforme: A systematic review. J Am Acad Dermatol.2015;72(2):239-245.e4.

3. Martínez-Pérez M, Imbernón-Moya A, Lobato-Berezo A,Churruca-Grijelmo M. Exantema mucocutáneo inducidopor Mycoplasma pneumoniae: ¿un nuevo síndromeseparado del eritema multiforme? Un nuevo caso yrevisión de la literatura. Actas Dermosifiliogr [Internet].2016;107(7):e47–51. Available from: http://dx.doi.org/10.1016/j.ad.2015.09.023

4. Roy S. Mycoplasma pneumoniae-induced rash and mucositisis a distinct entity that needs more recognition. J Paediatr ChildHealth. 2020;56(4):645-6.

5. Sandhu R, Mareddy C, Itskowitz M, Mount CE, Bhanot N,Min Z. Mycoplasma-induced rash and mucositis in a youngpatient with red eyes, oral mucositis, and targetoid cutaneousvesicles. Lancet Infect Dis [Internet]. 2017;17(5):562. Availablefrom: http://dx.doi.org/10.1016/S1473-3099(16)30515-1.

6. Meyer PM, Goetschel P, Lautenschlager S. Mycoplasma pneumoniaeand mucositis - Part of the Stevens-Johnson syndromespectrum. JDDG - J Ger Soc Dermatology. 2012;10(10):740-5.

7. Gise R, Elhusseiny AM, Scelfo C, Mantagos IS. MycoplasmaPneumoniae–Induced Rash and Mucositis: A LongitudinalPerspective and Proposed Management Criteria. Am JOphthalmol [Internet]. 2020;219:351-6. Available from:https://doi.org/10.1016/j.ajo.2020.06.010

8. Liotti L, Caimmi S, Bottau P, Bernardini R, Cardinale F, SarettaF, et al. Clinical features, outcomes and treatment inchildren with drug induced Stevens-Johnson syndrome andtoxic epidermal necrolysis. Acta Biomed. 2019;90(1):52-60.

9. Latsch K, Girschick HJ, Abele-Horn M. Stevens-Johnsonsyndrome without skin lesions. J Med Microbiol.2007;56(12):1696-9.

10. Li HO, Colantonio S, Ramien ML. Treatment of Mycoplasmapneumoniae-Induced Rash and Mucositis With Cyclosporine.J Cutan Med Surg. 2019;23(6):608-12.