Case Number : Case 2358 - 3 July 2019 Posted By: Dr. Hafeez Diwan

Erythema multiforme and the oral ulcers may be associated with herpes virus infection.

I don't see herpes-related changes but...yes, agree with a Steven-Johnson syndrome!

There is sub-epidermal split at the edge of biopsy with significant interface changes and a rather dense dermal inflammation.

While SJS/TEN is a possibility (histologically in part of the specimen) more clinical information is required including drug exposure  and % BSA detachment.

I would consider a TEN-like lupus/bullous LE in the differential diagnosis, this is a rare florid acute presentation of lupus especially SLE and serology/DIF may shed more light on the relevance of this possibly in such a young female.

Erythema multiforme - drug induced

16 hours ago, vincenzo said:

I don't see herpes-related changes but...yes, agree with a Steven-Johnson syndrome!

Sorry, maybe I didn´t expressed myself correctly. I think the oral lesions the patient has may be associated with herpes, and this rash on arms are due to erythema multiforme. But I liked the hypothesis of Stevens-Johnson as well.

8 hours ago, IgorSC said:

Sorry, maybe I didn´t expressed myself correctly. I think the oral lesions the patient has may be associated with herpes, and this rash on arms are due to erythema multiforme. But I liked the hypothesis of Stevens-Johnson as well.

Sorry, Igor, it is me who misunderstood.

Steven Johnson Syndrome.

Erythema multifome. She presently doesn't have aphthous stomatitis (she had it in the past).  She currently has targetoid lesions.