Recurrent and continuous erythema multiforme--a clinical and immunological study.

Summary A series of 26 patients with recurrent erythema multiforme was studied. A distinct clinical and immunological subgroup was found called ‘continuous erythema multiforme’ characterized by the presence of atypical lesions in addition to typical lesions, both of which occur continuously and a high level of circulating immune complexes with low levels of haemolytic complement. Herpes labialis preceded erythema multiforme in 17 of the 26 patients (65%) but in no cases could live virus be isolated from the lesions of erythema multiforme. Circulating immune complexes were found in 50 of 129 sera, being found in only 18 % sera between attacks and more commonly in the first 24 h of erythema multiforme lesions (58%). Immunological studies failed to provide conclusive evidence that erythema multiforme is solely immune complex mediated.