Oral Erythema Multiforme: A Case Report and Review of Diagnostic, Therapeutic and Prognostic Challenges

Abstract

Erythema multiforme (EM) presents a distinct challenge in both diagnosis and management, particularly when its manifestations extend to the oral cavity. Classified into "minor" and "major" forms based on clinical presentation, EM defies gender bias and tends to affect individuals across different age groups. The complexity arises from its varied symptoms within the oral cavity, where it commonly manifests as painful, red erosive plaques known as target lesions, primarily observed on the lips and oral mucosa. These lesions may arise independently or be linked to underlying systemic or infectious conditions, complicating the diagnostic process. Here, we present a case study of a 55-year-old female patient grappling with EM, underscoring the importance of meticulous clinical examination, thorough investigations, tailored treatment strategies, and subsequent outcomes.

Keywords: autoimmune like; case report; corticosteroids; erythema multiforme; oral mucosal disease.

Figure 1. A: Necrotic encrustations in the lower lip; B and C: Ulcerations involving the right and left buccal mucosa

Figure 2. Images depicting partial remission of lip lesions and complete remission of lesions in the right and left buccal mucosa

Figure 3. Image showing complete remission of the lesion in the lower lip

Figure 4. Photomicrograph of the 40X - H and E section showing non-keratinized stratified squamous epithelium ulcerated with separation of spinous cells and degeneration, showing a split between the epithelium and connective tissue.