Reactive infectious mucocutaneous eruption - Revision history

Aidan: /* Differential Diagnosis */

2026-04-13T20:17:52Z

Differential Diagnosis

← Older revision		Revision as of 20:17, 13 April 2026
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	* [[SJS]]/[[TEN]]		* [[SJS]]/[[TEN]]
			* [[Kawasaki disease]]

	== Investigations ==		== Investigations ==

Aidan: /* Management */

2026-04-13T20:02:22Z

Management

← Older revision		Revision as of 20:02, 13 April 2026
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	* Low threshold for Dermatology consult to help with diagnosis and treatment		* Low threshold for Dermatology consult to help with diagnosis and treatment
	* Consider Ophthalmology consult for patients with ocular involvement		* Consider Ophthalmology consult for patients with ocular involvement
			* Often receive antibiotics, particularly when considering a bacterial infectious trigger
	* In case reports or case series, patients have received high-dose [[corticosteroids]] (1-2 mg/kg IV [[methylprednisolone]] or 1 mg/kg p.o. [[prednisone]] for 3 to 5 days +/- taper), [[IVIG]], [[cyclosporine]], and [[etanercept]]		* In case reports or case series, patients have received high-dose [[corticosteroids]] (1-2 mg/kg IV [[methylprednisolone]] or 1 mg/kg p.o. [[prednisone]] for 3 to 5 days +/- taper), [[IVIG]], [[cyclosporine]], and [[etanercept]]

Aidan at 20:01, 13 April 2026

2026-04-13T20:01:22Z

← Older revision		Revision as of 20:01, 13 April 2026
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	** Vesiculobullous lesions are most common, followed by targetoid, papular, macular, and morbilliform		** Vesiculobullous lesions are most common, followed by targetoid, papular, macular, and morbilliform
	** Present on extremities and/or trunk		** Present on extremities and/or trunk

			== Differential Diagnosis ==

			* [[SJS]]/[[TEN]]

			== Investigations ==

			* Routine investigations
			* Consider chest x-ray to assess for respiratory infection
			* Consider NP swab for viral PCR, [[Mycoplasma pneumoniae]], and [[Chlamydophila pneumoniae]]
			* May need biopsy, though on biopsy it is indistinguishable from SJS/TEN

	== Diagnosis ==		== Diagnosis ==
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	** Vesiculobullous lesions or atypical targets affecting less than 10% of body surface area		** Vesiculobullous lesions or atypical targets affecting less than 10% of body surface area
	* Evidence of an infectious trigger can include history of cough, fever, malaise, and arthralgias in the preceding 7 to 10 days, or signs of respiratory infection on clinical examination		* Evidence of an infectious trigger can include history of cough, fever, malaise, and arthralgias in the preceding 7 to 10 days, or signs of respiratory infection on clinical examination
			* Supporting features include prodromal symptoms in the preceding 7 to 10 days, or histology ruling out other diagnoses

	== Management ==		== Management ==
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	* Not well studied		* Not well studied
	* Supportive care: fluids, nutrition, and pain management		* Supportive care: fluids, nutrition, and pain management
			* Low threshold for Dermatology consult to help with diagnosis and treatment
	* Consider Ophthalmology consult for patients with ocular involvement		* Consider Ophthalmology consult for patients with ocular involvement
	* In case reports or case series, patients have received high-dose [[corticosteroids]] (1-2 mg/kg IV [[methylprednisolone]] or 1 mg/kg p.o. [[prednisone]] for 3 to 5 days +/- taper), [[IVIG]], [[cyclosporine]], and [[etanercept]]		* In case reports or case series, patients have received high-dose [[corticosteroids]] (1-2 mg/kg IV [[methylprednisolone]] or 1 mg/kg p.o. [[prednisone]] for 3 to 5 days +/- taper), [[IVIG]], [[cyclosporine]], and [[etanercept]]

Aidan at 19:58, 13 April 2026

2026-04-13T19:58:35Z

← Older revision		Revision as of 19:58, 13 April 2026
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	* Diagnosis and management of reactive infectious mucocutaneous eruption. J Hosp Med. 2025 Nov;20(11):1212-1216. doi: [https://doi.org/10.1002/jhm.70099 10.1002/jhm.70099]. Epub 2025 Jul 7. PMID: [https://pubmed.ncbi.nlm.nih.gov/40619921/ 40619921]; PMCID: [https://pmc.ncbi.nlm.nih.gov/articles/PMC12579755/ PMC12579755].		* Diagnosis and management of reactive infectious mucocutaneous eruption. J Hosp Med. 2025 Nov;20(11):1212-1216. doi: [https://doi.org/10.1002/jhm.70099 10.1002/jhm.70099]. Epub 2025 Jul 7. PMID: [https://pubmed.ncbi.nlm.nih.gov/40619921/ 40619921]; PMCID: [https://pmc.ncbi.nlm.nih.gov/articles/PMC12579755/ PMC12579755].
			[[Category:Dermatology]]

Aidan: Created page with "== Background == * RIME is a mucosal or mucocutaneous eruption following Mycoplasma pneumoniae infections ** Other suspected causative infections include Chlamydophila pneumoniae, human metapneumovirus, human parainfluenza virus 2, rhinovirus, enterovirus, influenza A and B, COVID‐19, and adenovirus * Similar to a postinfectious Stevens-Johnson syndrome, though more common in younger patients with notable mucosal..."

2026-04-13T19:57:39Z

Created page with "== Background == * RIME is a mucosal or mucocutaneous eruption following Mycoplasma pneumoniae infections ** Other suspected causative infections include Chlamydophila pneumoniae, human metapneumovirus, human parainfluenza virus 2, rhinovirus, enterovirus, influenza A and B, COVID‐19, and adenovirus * Similar to a postinfectious Stevens-Johnson syndrome, though more common in younger patients with notable mucosal..."

New page

== Background ==

* RIME is a mucosal or mucocutaneous eruption following [[Mycoplasma pneumoniae]] infections
** Other suspected causative infections include [[Chlamydophila pneumoniae]], [[human metapneumovirus]], [[human parainfluenza virus 2]], [[rhinovirus]], [[enterovirus]], [[Influenza virus|influenza A and B]], [[COVID‐19]], and [[adenovirus]]
* Similar to a postinfectious [[Stevens-Johnson syndrome]], though more common in younger patients with notable mucosal findings and absent or minimal cutaneous findings

== Clinical Manifestations ==

* Prodrome of fever, cough, and malaise lasting 3 to 13 days (median 8 days)
* Usually two or more mucosal surfaces involved, including oral (most common, in 95% of cases), ocular (next most common, in around 90%), urogenital (about 60%), and anal or esophageal surfaces (least common)
** Oral: erosions, ulcers, vesicular or vesiculobullous lesions, or desquamation
** Ocular: bilateral conjunctivitis (often purulent), conjunctival injection, or hyperemia
** Urogenital: more commonly described in female patients
* May have skin involvement, though absent in 1/3 and sparse in 1/2 of cases
** Vesiculobullous lesions are most common, followed by targetoid, papular, macular, and morbilliform
** Present on extremities and/or trunk

== Diagnosis ==

* Evidence of an infectious trigger, with at least 2 of:
** Non-contributory medication history
** Erosive mucositis affecting 2 or more sites
** Vesiculobullous lesions or atypical targets affecting less than 10% of body surface area
* Evidence of an infectious trigger can include history of cough, fever, malaise, and arthralgias in the preceding 7 to 10 days, or signs of respiratory infection on clinical examination

== Management ==

* Not well studied
* Supportive care: fluids, nutrition, and pain management
* Consider Ophthalmology consult for patients with ocular involvement
* In case reports or case series, patients have received high-dose [[corticosteroids]] (1-2 mg/kg IV [[methylprednisolone]] or 1 mg/kg p.o. [[prednisone]] for 3 to 5 days +/- taper), [[IVIG]], [[cyclosporine]], and [[etanercept]]

== Further Reading ==

* Diagnosis and management of reactive infectious mucocutaneous eruption. J Hosp Med. 2025 Nov;20(11):1212-1216. doi: [https://doi.org/10.1002/jhm.70099 10.1002/jhm.70099]. Epub 2025 Jul 7. PMID: [https://pubmed.ncbi.nlm.nih.gov/40619921/ 40619921]; PMCID: [https://pmc.ncbi.nlm.nih.gov/articles/PMC12579755/ PMC12579755].