Corticosteroid treatment of erythema multiforme major (Stevens-Johnson syndrome) in children

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Abstract
The effectiveness of systemic corticosteroids in erythema multiforme major (EMM) is controversial. We therefore evaluated the efficacy of corticosteroids in the treatment of EMM in a prospective study of 16 children with EMM admitted to our department within 3 days from the onset of rash. Ten patients (group A) received bolus infusions of methylprednisolone (4 mg/kg/day) while six had only supportive treatment (group B). The early use of corticosteroids compared to supportive treatment resulted in: (1) significant reduction of the period of fever (4.0 ± 1.9 vs 9.5 ± 4.2 days P = 0.01); (2) reduction of the period of acute eruption (7.0 ± 3.3 versus 9.8 ± 3.0 days P = 0.08); and (3) milder signs of prostration. Complications were minimal in both groups. Conclusion The early and short course of corticosteroids favourably influences the course of erythema multiforme major in children.

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