Anemia as a convoluted cause of pediatric drug-induced erythema multiforme: A case report

Objective: Drug-induced erythema multiforme (DIEM) is an acute, immune-mediated dermatologic disease due to adverse reactions to certain drugs. Typically DIEM will resolve in 10-14 days. Yet hematological factors can result in more severe DIEM and slows healing. This case reporting DIEM and highlighting anemia as the convoluted cause. Methods: The patient was advised to stop the previous oral anti-inflammatory drugs. Progressive black-desquamative ulcers on lips followed by blood encrustation of a 3-year-old boy were managed with saline debridement and antihistamines, topical corticosteroid, oral analgesic, combined with antibiotic ointment. The prolonged healing process of DIEM urged a complete blood count to be carried out and anemia was found. The iron syrup was then supplemented. Results: Lesion healing was speed up and parent’s satisfaction was reached. Conclusion: The identification of convoluted cause of prolong pediatric DIEM shows the importance of distinguishing the etiology to gain effective treatment.