Ocular complications in erythema exudativum multiforme with mucous membrane lesions.

ERYTHEMA exudativum multiforme is a specific skin disease of unknown aetiology which may be associated with various syndromes in which the mucous membranes-conjunctiva, lips, bronchi and ano-genital region-are affected, and consequently fall in the domain of the dermatologist, physician, ophthalmologist and uro-genital surgeon. As its name implies, erythema multiforme is characterised by the varied forms of its lesions. Hence no two cases are identical, and owing to the diverse characters of the syndromes a great deal of confusion has resulted in the literature. Authors in various countries had believed that they had discovered a new disease. Hence the multiplicity of names applied to the syndromes, as will be described below. We are in agreemnent with Sneddon who states that erythema multiforme and its syndrome represent different clinical entities, while Grove and Meisenhelder and others believe the syndrome merely to be a manifestation of erythema multiforme. Several articles on the subject have appeared in the last few years, so that our knowledge of the disease has increased. A review of the subject shows that as long ago as 1822 Alibert and Bazin (quoted by Beaudonnet) noted that patients suffering from erythema multiforme sometimes presented a conjunctivitis. According to Steffens, Rigler gave the first detailed description of conjunctivitis complicating erythema multiforme in 1852. The name erythema exudativum multiforme was proposed by Hebra in 1866 to denote the erythematous skin lesions while Kaposi used the term " erythema polymorphe." The interesting earlier papers were by Fuchs (1876), Beaudonnet (1894), During (1896), Brault and Steffens (1902) and Salus (1912). The origin of the names " pluriorificial erosive ectodermosis," "dermostomatitis " and " Stevens-Johnson disease " has been traced in the following manner: Rendu (1916). Fiessinger and Rendu (1917) saw a number of acute cases occurring in soldiers on the French front, and to these the name of pluriorificial erosive ectodermosis was applied (see also Berho).