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. 2013 Jun;59(6):635-6.

Erythema multiforme in children: the steroid debate

Melissa Chan  1 , Ran D Goldman
Affiliations

Erythema multiforme in children: the steroid debate

Melissa Chan et al. Can Fam Physician. 2013 Jun.

Abstract
in English, French

Question: In my office I occasionally see children who have rashes with "target lesions" and who are diagnosed with erythema multiforme (EM). When should these children receive steroids, and when should the illness be allowed to follow its natural course without steroid treatment?

Answer: Erythema multiforme is relatively common in children. Current recommendations suggest not to treat EM minor with systemic steroids and that topical steroids might be of benefit. The use of systemic steroids for EM major remains controversial, as there is evidence both for and against treatment, and no randomized controlled trials have been done. Further studies need to address the benefit of steroids, and in the interim, physicians should decide on a treatment based on the severity of EM and in consultation with a dermatologist, if available.

Question Je vois occasionnellement à mon cabinet des enfants qui ont des éruptions cutanées avec «lésions ciblées» chez qui on a diagnostiqué un érythème polymorphe (EP). Quand ces enfants devraient-ils recevoir des stéroïdes et quand devrait-on laisser le problème suivre son cours naturel sans traitement aux stéroïdes?

Réponse L’érythème polymorphe est relativement courant chez les enfants. Les recommandations actuelles sont de ne pas traiter l’EP mineur avec des stéroïdes systémiques, tout en indiquant que les stéroïdes topiques pourraient apporter des bienfaits. L’utilisation des stéroïdes systémiques demeure controversée, car il y a des données probantes en faveur et contre ce traitement, et aucune étude contrôlée randomisée n’a été effectuée. Il faudrait que d’autres études se penchent sur les bienfaits des stéroïdes; entre-temps, les médecins devraient décider du traitement en fonction de la gravité de l’EP et en consultation avec un dermatologue, si possible.

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