SEVERE ERYTHEMA MULTIFORME WITH INTESTINAL INVOLVEMENT

Abstract

Under various names (severe erythema multiforme, Stevens-Johnson's disease, erythema multiforme exudativum and ectodermosis erosiva pluriorificialis), the literature indicates infrequent involvement of the alimentary canal in the toxic eruption commonly known as erythema multiforme. In 1874 Hebra¹reported a patient with "erythema gyratum" in whom the autopsy revealed "... in the small bowels similar red circles as on the skin." In 1895, 1900 and 1904, Osler²published groups of cases, totaling 29, the disease in which he first described as erythema multiforme. In several of these cases there were signs and symptoms referable to the alimentary canal. However, in 1914 Osler³revised his view in an article referring to most of these cases as examples of Henoch's and Schönlein's purpura. Lever⁴and Costello⁵each published reviews and case studies in more recent years. Of Lever's 2 patients, neither had signs or symptoms of lesions in the gastrointestinal