Diagnostic Challenges in a Pediatric Case of Recurrent Blistering Skin Reactions: Ibuprofen-Induced Fixed Drug Exanthema versus Infection-Triggered Erythema Multiforme

Möhrle R, Toni I, Wagner N, Schliep S, Hörning A, Neubert A (2026)

Publication Type: Journal article

Publication year: 2026

Journal

Drug, Healthcare and Patient Safety Dove Medical Press

Book Volume: 18

Article Number: 584720

DOI: 10.2147/DHPS.S584720

Abstract

A 12-year-old patient was hospitalized with suspected recurrent Stevens-Johnson syndrome (SJS) caused by ibuprofen. The patient presented with aphthous lesions on the lips and oral mucosa, accompanied by fever and cough. Further examination revealed more severe symptoms. The exact classification of his skin reaction and the underlying cause were challenging due to the coexistence of multiple potential triggers. The diagnostic overlap among various skin reactions requires careful evaluation of the clinical presentation and histopathological findings in relation to potential drug exposure and/or infectious triggers. Cutaneous reactions such as SJS and fixed drug exanthema are predominantly associated with drug exposure, whereas Erythema multiforme (EM) and Mycoplasma pneumoniae rash and mucositis (MIRM) are mainly linked to infectious triggers. The diagnosis of a skin reaction and its trigger is highly relevant for therapy and prevention of further episodes. In this patient, administration of ibuprofen, as well as infections with Herpes simplex virus (HSV) and Mycoplasma pneumoniae (M. pneumoniae) were considered potential triggers, highlighting the complexity of this case. The patient recovered following extensive therapy and was discharged after two weeks.

Authors with CRIS profile

Ramona Möhrle Department of Paediatrics and Adolescent Medicine Irmgard Toni Department of Paediatrics and Adolescent Medicine Nicola Wagner Department of Dermatology Stefan Schliep Department of Dermatology Andre Hörning Department of Paediatrics and Adolescent Medicine Antje Neubert Department of Paediatrics and Adolescent Medicine

How to cite

APA:

Möhrle, R., Toni, I., Wagner, N., Schliep, S., Hörning, A., & Neubert, A. (2026). Diagnostic Challenges in a Pediatric Case of Recurrent Blistering Skin Reactions: Ibuprofen-Induced Fixed Drug Exanthema versus Infection-Triggered Erythema Multiforme. Drug, Healthcare and Patient Safety , 18. https://doi.org/10.2147/DHPS.S584720

MLA:

Möhrle, Ramona, et al. "Diagnostic Challenges in a Pediatric Case of Recurrent Blistering Skin Reactions: Ibuprofen-Induced Fixed Drug Exanthema versus Infection-Triggered Erythema Multiforme." Drug, Healthcare and Patient Safety 18 (2026).

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