Erythema multiforme (EM) is a clinical enigma which reflects the broad morphological spectrum of the lesions. There is molecular and immunological evidence that herpes simplex virus (HSV) causes some EM lesions (herpes-associated EM).
The aim of our research was to analyze the clinical manifestations and anamnesis of patients with erythema multiforme associated with HSV infection.
We studied 82 patients (38 men and 44 women aged 18 to 65 years) with erythema multiforme. All patients had a history of recurrent forms of herpes simplex infection. In most of patients EM was associated with activation of the herpes virus infection on the skin or mucous membranes. The diagnosis of HSV infection was confirmed by ELISA test and by the polymerase chain reaction. The clinical, laboratory and morphological differences between infectious-allergic (herpes simplex-associated) and toxic-allergic (drug) multiform exudative erythema was identified. Our results suggest these forms most probably are of different nosological units rather than a single disease. Our data suggest that autoimmune T-cells triggered by HSV infection play decisive role in pathogenesis of herpes-associated erythema multiformis.