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Erythema multiforme is an inflammatory skin and mucosal disease mainly related to infectious agents such as Herpes simplex virus, Mycoplasma pneumoniae , though it can also be "idiopathic". The characteristic skin lesions are typical or atypical acral raised target lesions. The oral mucosa can be affected, alone or in combination with other mucosal/cutaneous sites, sometimes causing extreme pain, severely impacting food intake, and warranting hospitalization. A comprehensive understanding of erythema multiforme clinical characteristics, triggering agents, and differential diagnosis including Stevens-Johnson syndrome/Toxic Epidermal Necrolysis, is crucial to conduct proper workup and management. Mycoplasma pneumoniae infection should be immediately ruled out because of the need of antibiotics. The cornerstone of management is symptomatic treatment and will be detailed in this review as well as the etiologic treatment. Lastly, the management of persistent or recurrent erythema multiforme can be challenging, especially when antivirals fail to prevent a relapse, but breakthrough treatments have been reported successful in this difficult-to-treat subset of patients., Funding: The Funding was provided by the University of Sherbrooke Faculty of Medicine and Health Sciences., Competing Interests: None., (© 2024 Published by Elsevier Ltd.)

Imiquimod is a well-known topical treatment for its efficacy against various skin conditions. While generally well-tolerated, adverse reactions like local skin irritation are common. However, severe systemic effects such as Stevens-Johnson syndrome (SJS) are rare, but possible. We present the case of an 82-year-old male who developed SJS following topical Imiquimod therapy for basal cell carcinoma. Despite minimal systemic absorption, serious reactions can occur, warranting caution. Prompt recognition and discontinuation of treatment are crucial for managing such rare but severe adverse events. This case underscores the importance of informed consent and vigilant monitoring for adverse reactions associated with Imiquimod therapy., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

Fixed drug eruption (FDE) is a cutaneous drug reaction characterised by recurrent skin lesions occurring at the same site after each exposure to a causative agent. There is currently limited evidence in the paediatric population. The objective of this systematic review is to investigate the clinical features, causative agents and management of paediatric FDE. A systematic search of the English and French literature on paediatric FDE was conducted using the Medline and Embase databases. After full-text article review, 92 articles were included, representing a total of 233 patients. Antibiotics were the most frequent triggering agents, mainly sulfonamides (65.0% of antibiotics). Systemic symptoms were rare, and most patients only received supportive therapy. One hundred and six patients (106) performed a test to confirm the causative agent. Of these, 72.6% had oral provocation tests (OPTs) and 28.3% had patch tests. The patient's age, presence of bullous lesions and mucosal lesions were similar between tested and untested patients. It did not seem to influence the decision to perform OPTs. Paediatric FDE is a non-severe skin drug reaction. Antibiotics were the most reported triggering agents. Drug testing, including oral provocation test, was safely performed in the paediatric population., (© 2024 The Authors. Contact Dermatitis published by John Wiley & Sons Ltd.)