The aetiology is not clear and though the disease may be reaction to a variety of causes, no convincing mechanism has been proposed. Infections, particularly herpetic, can be triggering factors. Drugs, particularly sulphonamides and barbiturates, have also been implicated, but a positive drug history is also rare. Even when drugs have been taken, coincidence cannot always be excluded and in most patients no precipitating cause can be found.
- The disease more frequently affects young men between the ages of 20 and 30 years.
- The oral lesions present as coalescing small vesicles that rupture within two or three days, leaving irregular, painful erosions covered by a necrotic pseudomembrane. The lips, buccal mucosa, tongue, soft palate, and floor of the mouth are most commonly involved.
- The skin manifestations consist of erythematous, flat, round macules, papules, or plaques, usually in a symmetrical pattern. The characteristic skin patterns are target- or iris-like lesions. Skin bullae may occasionally be seen.
- Conjunctivitis, balanitis, vulvitis, and prodromal symptoms such as headache, malaise, arthralgias, and fever, may also be present. Recurrences are common.
- Primary herpetic gingivostomatitis
- aphthous ulcers
- erosive lichen planus
- pemphigus vulgaris
There is no specific treatment. Systemic corticosteroids may give symptomatic relief. Antibiotics are usually also given in severe cases with the idea of preventing secondary infection. Levamisole has also been reported to be effective. In some cases aciclovir is effective.