Adenovirus-Induced Erythema Multiforme: Eye And Genital Mucosal Involvement Is Specific, Whereas Oral And Cutaneous Involvement Is Not

Erythema multiforme (EM) is an acute polymorphous mucocutaneous eruption characterized by target lesions typically located on acral extremities. Erythema multiforme major (EMM) is defined as EM involving at least two mucosal sites (1). Unlike Stevens-Johnson syndrome (SJS), which is mostly caused by drugs, EM is a hypersensitive response to infection (2). Herpes simplex virus (HSV) and Mycoplasma pneumoniae are the most common triggers.Human adenovirus (HAdV) has been implicated in both EMM and SJS (3, 4), and has also been linked to a clinical entity resembling EMM called ectodermosis erosive pluriorificialis (5).HAdV is a double-stranded DNA virus, classified into 7 species (A to G), with at least 100 different types (6). HAdV-D37 is a frequent cause of keratoconjunctivitis that has also been reported in urethritis, sometimes concomitantly (7, 8). Its contagiousness necessitates isolation of the patient (9). We describe here two cases of EMM induced by adenovirus. We investigated the role of adenovirus in the pathogenesis of the various mucosal lesions observed.