Erythema Multiforme as a Complication in a Woman With Herpes Zoster

Agnes Stephanie Tanuwijaya, Niken Kusumaningrum, Hari Darmawan

Sari


ABSTRACT

 

Globally, the incidence of erythema multiforme (EM) is estimated to be between 0.01 and 1%, with a frequency of approximately 1.2 to 6 cases per million people per year. This condition can be triggered by viral infections, one of which is the varicella-zoster virus (VZV). Herpes zoster occurs due to reactivation of VZV and can cause EM. This condition requires special attention due to its potential severity and diagnostic difficulties. This case presentation describes this rare occurrence in a 43-year-old woman, exploring the clinical presentation, diagnostic approach, and therapeutic management of this unusual combination of virus-induced dermatological manifestations. The patient was given a combination of systemic corticosteroids and antivirals, as well as antibiotics and medications for other symptomatic symptoms. After a three-day hospital stay that showed clinical improvement, the patient was discharged with continued outpatient follow-up and a process to continue the prescribed oral and topical treatment with an appropriate reduction in the systemic corticosteroid dose.

 

Keywords: Erythema Multiforme, Herpes Zoster, Herpes Zoster-Associated Erythema Multiforme (HAEM), Corticosteroid, Antiviral.


Teks Lengkap:

Download Artikel

Referensi


Alkhaleefa, A., Campbell, B., Omotajo, D., & Hardin, J. (2022). Erythema multiforme (EM): Pathophysiology and clinical findings. Calgary Guide [Internet]. https://calgaryguide.ucalgary.ca/erythema-multiforme-em-pathophysiology-and-clinical-findings/erythema-multiforme/

Chan, X.B.V., Tan, N.C., Ng, M.C.W., Ng, D.X., Koh, Y.L.E., Aau, W.K., Ng, C.J. (2023). Prevalence and healthcare utilization in managing herpes zoster in primary care: a retrospective study in an Asian urban population. Frontiers in Public Health, 11, 1213736. https://doi.org/10.3389/fpubh.2023.1213736

Chen, J., Abrahamson, P. E., Ke, Y., Ong, C. R., Parikh, R., & Shantakumar, S. (2024). A systematic literature review of the epidemiology and burden of herpes zoster in selected locales in Asia Pacific. Human vaccines & immunotherapeutics, 20(1), 2344983. https://doi.org/10.1080/21645515.2024.2344983

de Souza Camargo, H., de Oliveira, D.D.S., de Oliveira Barbeiro, C., Esteves, V.Z., Bufalino, A., Massucato, E.M.S., Navarro, C.M. (2024). Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 137(6), e204. https://doi.org/10.1016/j.oooo.2023.12.279

Dilly, J. T., Kapantow, M. G., & Suling, P. L. (2016). Profil herpes zoster di poliklinik kulit dan kelamin RSUP Prof. Dr. R. D. Kandou Manado periode Januari - Desember 2013. E-CliniC, 4(2). https://doi.org/10.35790/ecl.v4i2.14563

Gnann Jr., J. W. (2007). Antiviral therapy of varicella-zoster virus infections. In A. Arvin (Eds.) et. al., Human Herpesviruses: Biology, Therapy, and Immunoprophylaxis. Cambridge University Press.

Hafsi, W., & Badri, T. (2024). Erythema Multiforme. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK470259/

Hasan, S., Jangra, J., Choudhary, P., Mishra, S. (2018). Erythema Multiforme: A Recent Update. Biomedical and Pharmacology Journal, 11(1). https://dx.doi.org/10.13005/bpj/1358

Hodgens, A., & Sharman, T. (2023). Corticosteroids. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK554612/

Hosea, F. E., & Praharsini, I. G. A. A. . (2025). Characteristic of Herpes Zoster in the Elderly at Prof. Dr. I.G.N.G. Ngoerah General Hospital: An Epidemiologic Study. Berkala Ilmu Kesehatan Kulit Dan Kelamin, 37(2), 84–89. https://doi.org/10.20473/bikkk.V37.2.2025.84-89

Katz, J., Livneh, A., Shemer, J., Danon, Y. L., & Peretz, B. (1999). Herpes simplex-associated erythema multiforme (HAEM): a clinical therapeutic dilemma. Pediatric dentistry, 21(6), 359–362.

Królicka, A. L., Kruczkowska, A., Krajewska, M., & Kusztal, M. A. (2020). Hyponatremia in Infectious Diseases-A Literature Review. International journal of environmental research and public health, 17(15), 5320. https://doi.org/10.3390/ijerph17155320

Menaldi, S. L., Halim, P. A., & Kurniawan, K. (2022). Efficacy of gabapentinoids for acute herpes zoster in preventing postherpetic neuralgia: a systematic review of randomized controlled trials. Dermatology online journal, 28(5), 10.5070/D328559238. https://doi.org/10.5070/D328559238

Michaels B. (2009). The role of systemic corticosteroid therapy in erythema multiforme major and stevens-johnson syndrome: a review of past and current opinions. The Journal of clinical and aesthetic dermatology, 2(3), 51–55.

Muryah, A.E., & Sufiawati, I. (2017). Successful treatment of herpes simplex-associated erythema multiforme with a combination of acyclovir and prednisone. Journal of Dental, Jaw and Face Development and Science, 2(3).

Sankari, S. L., Babu, N. A., Rajesh, E., & Kasthuri, M. (2015). Apoptosis in immune-mediated diseases. Journal of pharmacy & bioallied sciences, 7(Suppl 1), S200–S202. https://doi.org/10.4103/0975-7406.155902

San Martin, P., Aunhachoke, K., Batac, M. C. F., Lodrono-Lim, K., Kwanthitinan, C., Santoso, D., Fonseka, T., Nguyen, M., & Guzman-Holst, A. (2023). Systematic Literature Review of Herpes Zoster Disease Burden in Southeast Asia. Infectious diseases and therapy, 12(6), 1553–1578. https://doi.org/10.1007/s40121-023-00822-0

Soares, A., & Sokumbi, O. (2021). Recent Updates in the Treatment of Erythema Multiforme. Medicina (Kaunas, Lithuania), 57(9), 921. https://doi.org/10.3390/medicina57090921

Sokumbi, O., & Wetter, D. A. (2012). Clinical features, diagnosis, and treatment of erythema multiforme: a review for the practicing dermatologist. International journal of dermatology, 51(8), 889–902. https://doi.org/10.1111/j.1365-4632.2011.05348.x

Susanto, H., Nurhilailah, Ganesha, R., Hendarti, H.T., Hadi, P. (2021). Herpes-associated erythema multiforme in a postmenopausal woman. Majalah Kedokteran Gigi Indonesia, 7(1), 51-59. http://doi.org/10.22146/majkedgiind.43299

Taylor, M., & Gerriets, V. (2023). Acyclovir. StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK542180/

Trayes, K. P., Love, G., & Studdiford, J. S. (2019). Erythema Multiforme: Recognition and Management. American family physician, 100(2), 82–88.

Wollina, U., & Gemmeke, A. (2009). Herpes zoster - associated erythema multiforme. Journal of dermatological case reports, 3(1), 11–13. https://doi.org/10.3315/jdcr.2009.1025

Zhu, Q., Wang, D., Peng, D., Xuan, X., & Zhang, G. (2022). Erythema multiforme caused by varicella-zoster virus: A case report. SAGE open medical case reports, 10, 2050313X221127657. https://doi.org/10.1177/2050313X221127657




DOI: https://doi.org/10.33024/mahesa.v6i6.23169

Refbacks

  • Saat ini tidak ada refbacks.


Publisher: Universitas Malahayati Lampung

Creative Commons License
Semua artikel dapat digunakan dibawah lisensi Creative Commons Attribution-ShareAlike 4.0 International License